Xia Yinghua, Yu Gui, Min Feixiang, Xiang Hui, Huang Jinqing, Leng Jingxing
Medical College of Nanchang University, Nanchang, People's Republic of China.
Department of Neurosurgery, Jiangxi Provincial People's Hospital, Nanchang, People's Republic of China.
J Pain Res. 2022 Sep 29;15:3059-3068. doi: 10.2147/JPR.S374433. eCollection 2022.
Trigeminal neuralgia is a condition confined to the trigeminal nerve, causing one or more branches of facial nerve pain. Surgical treatment options for trigeminal neuralgia include microvascular decompression(MVD), percutaneous balloon compression (PBC), radiofrequency thermocoagulation(RF), percutaneous retrogasserian glycerol rhizotomy(PRGR), gamma knife, etc. Of these treatments, PBC is increasingly being used by clinicians for trigeminal neuralgia. PBC is a simple surgical operation performed to treat trigeminal neuralgia. Owing to its advantages, PBC is favored by many clinicians. In this study, we aimed to emphasize the need to analyze the shape of the balloon, position, compression time, and pressure, as these factors can affect the efficacy of PBC. The relief of pain by balloon compression is related to the shape of the balloon on X-ray, which is the key to the operation. Owing to continued progress and advances in current imaging technologies, clinicians revealed that the precise positioning of the foramen ovale is no longer an intraoperative problem. Instead, the anatomy of Meckel's cave and the shape of the balloon must be the focus to achieve the best treatment effect. For clinicians, PBC is simple and is associated with a short operation time. PBC also has other advantages, such as low cost and immediate postoperative pain relief. The recurrence rate of pain post-PBC is low, despite the occurrence of facial numbness post-op. However, this side effect is reversible and does not affect daily life of the patient. In fact, the patient can be discharged 1-2 days after surgery. Overall, PBC can be considered as one of the preferred surgical methods for the treatment of primary trigeminal neuralgia. In this paper, we explain the main points of PBC operation in detail in terms of Meckel's cave, surgical procedure, complications, discussion of the focus and new progress, etc.
三叉神经痛是一种局限于三叉神经的疾病,会导致面神经的一个或多个分支疼痛。三叉神经痛的外科治疗选择包括微血管减压术(MVD)、经皮球囊压迫术(PBC)、射频热凝术(RF)、经皮半月神经节甘油注射术(PRGR)、伽玛刀等。在这些治疗方法中,PBC越来越被临床医生用于治疗三叉神经痛。PBC是一种用于治疗三叉神经痛的简单外科手术。由于其优点,PBC受到许多临床医生的青睐。在本研究中,我们旨在强调分析球囊形状、位置、压迫时间和压力的必要性,因为这些因素会影响PBC的疗效。球囊压迫缓解疼痛与X射线下球囊的形状有关,这是手术的关键。由于当前成像技术的不断进步和发展,临床医生发现卵圆孔的精确定位已不再是术中问题。相反,为了达到最佳治疗效果,必须关注梅克尔腔的解剖结构和球囊的形状。对于临床医生来说,PBC操作简单,手术时间短。PBC还有其他优点,如成本低和术后疼痛立即缓解。尽管术后会出现面部麻木,但PBC术后疼痛复发率较低。然而,这种副作用是可逆的,不影响患者的日常生活。事实上,患者术后1-2天即可出院。总体而言,PBC可被视为治疗原发性三叉神经痛的首选手术方法之一。在本文中,我们从梅克尔腔、手术步骤、并发症、焦点讨论和新进展等方面详细解释了PBC手术的要点。