Wang Qiao, Chen Cheng, Guo Gangwen, Li Zhenxing, Huang Dong, Zhou Haocheng
Department of Pain, The Third Xiangya Hospital, Institute of Pain Medicine, Central South University, Changsha, Hunan, China.
Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China.
Pain Ther. 2021 Dec;10(2):1439-1450. doi: 10.1007/s40122-021-00311-7. Epub 2021 Aug 30.
Percutaneous balloon compression (PBC) is an effective and safe option for patients with trigeminal neuralgia. A pear-shaped balloon can be used to identify the proper compression of the Gasserian ganglion during the PBC procedure. The aim of this study was to evaluate the relationship between the foramen ovale (FO) size and intraluminal pressure of the pear-shaped balloon.
Thirteen patients that presented with classical trigeminal neuralgia were scheduled to undertake PBC surgery at the Pain Department of the Third Xiangya Hospital, Central South University, from November 2020 to April 2021. Three-dimensional computed tomography reconstruction of the skull base was performed to capture the feature of FO preoperatively. The intraluminal pressure was continuously recorded when a pear-shaped balloon was obtained during the procedure. Correlation analysis was calculated to determine the association of the intraluminal balloon pressure with FO parameter.
All participants reported complete relief of pain at discharge. The enduring analgesic effect of PBC was maintained in all patients with a median follow-up up to 5.5 months (range, 3-8 months). The average intraluminal balloon pressure was 161.5 ± 29.4 kPa at the initial compression (P1), and 134.8 ± 21.5 kPa at the ending of compression (P2), respectively. P1 was significantly correlated with the length (r = 0.61, P = 0.024) of FO. Similarly, a significant and positive correlation was observed between P2 and the length (r = 0.63, P = 0.022) of FO.
Preoperative assessment of FO may be a potential predictor of intraluminal pressure to reach a pear-shaped balloon during PBC treatment. Narrow FO is associated lower intraluminal balloon pressure.
经皮球囊压迫术（PBC）是三叉神经痛患者一种有效且安全的治疗选择。在PBC手术过程中，可使用梨形球囊来确定半月神经节的适当压迫程度。本研究的目的是评估卵圆孔（FO）大小与梨形球囊腔内压力之间的关系。
2020年11月至2021年4月，13例表现为典型三叉神经痛的患者计划在中南大学湘雅三医院疼痛科接受PBC手术。术前行颅底三维计算机断层扫描重建以获取术前FO的特征。手术过程中获取梨形球囊时持续记录腔内压力。计算相关性分析以确定球囊腔内压力与FO参数之间的关联。
所有参与者出院时均报告疼痛完全缓解。所有患者的PBC持久镇痛效果得以维持，中位随访时间达5.5个月（范围3 - 8个月）。初始压迫时（P1）球囊腔内平均压力为161.5±29.4 kPa，压迫结束时（P2）为134.8±21.5 kPa。P1与FO的长度显著相关（r = 0.61，P = 0.024）。同样，P2与FO的长度之间也观察到显著正相关（r = 0.63，P = 关于0.022）。
术前评估FO可能是PBC治疗期间达到梨形球囊腔内压力的潜在预测指标。FO狭窄与较低的球囊腔内压力相关。
