Omeis Ibrahim, Smith David, Kim Susan, Murali Raj
Department of Neurosurgery, New York Medical College, Valhalla and New York, NY, USA.
Stereotact Funct Neurosurg. 2008;86(4):259-65. doi: 10.1159/000138770. Epub 2008 Jun 13.
To analyze the long-term clinical outcomes and complication rates associated with percutaneous balloon compression (PBC) of the trigeminal ganglion in patients with recurrent trigeminal neuralgia (TN) who were treated surgically with procedures other than PBC.
In this retrospective study, the authors reviewed the results of 29 patients who underwent 41 PBC procedures for recurrent TN between 1998 and 2006.
The overall mean length of follow-up was 49 months (range 1-101). Pain relief was immediate in 24 (83%) patients. There was no pain relief in 5 patients (17%). 2 patients were lost to follow-up. 12 (54.5%) of 22 patients remained pain-free during a mean follow-up period of 65 months (range 40-101). The other 10 patients (45.5%) who had immediate pain relief experienced recurrent pain, with a mean time to recurrence of 7.3 months (17 days to 38 months). PBC was repeated in 11 patients, and was performed a third time in 2 patients. Morbidities included minor dysesthesia (2 patients), masseter weakness (2 patients), corneal anesthesia (1 patient), anesthesia dolorosa (1 patient), and subarachnoid hemorrhage (1 patient with history of multiple myeloma).
PBC is a useful treatment for patients with recurrent TN who have already been treated surgically. Long-term relief of pain in this subset of TN patients is achieved nearly half of the time with side-effect profiles similar to those reported in published data.
分析经皮穿刺球囊压迫术(PBC)治疗复发性三叉神经痛(TN)患者的长期临床疗效和并发症发生率,这些患者之前接受过除PBC以外的手术治疗。
在这项回顾性研究中,作者回顾了1998年至2006年间29例因复发性TN接受41次PBC手术患者的结果。
总体平均随访时间为49个月(范围1 - 101个月)。24例(83%)患者疼痛立即缓解。5例(17%)患者疼痛未缓解。2例患者失访。22例患者中有12例(54.5%)在平均65个月(范围40 - 101个月)的随访期内保持无痛。另外10例(45.5%)疼痛立即缓解的患者出现了复发性疼痛,平均复发时间为7.3个月(17天至38个月)。11例患者再次接受了PBC,2例患者接受了第三次PBC。并发症包括轻度感觉异常(2例)、咬肌无力(2例)、角膜麻醉(1例)、痛性麻木(1例)和蛛网膜下腔出血(1例患有多发性骨髓瘤病史的患者)。
PBC对于已经接受过手术治疗的复发性TN患者是一种有效的治疗方法。在这部分TN患者中,近一半的患者能够实现长期疼痛缓解,且副作用情况与已发表数据报道的相似。