Department of Neurosurgery, Hebei General Hospital, Shijiazhuang City, Hebei Province, China.
Department of Neurosurgery, Hebei General Hospital, Shijiazhuang City, Hebei Province, China.
Clin Neurol Neurosurg. 2024 Jul;242:108328. doi: 10.1016/j.clineuro.2024.108328. Epub 2024 May 15.
Percutaneous balloon compression (PBC) has been widely used in the treatment of trigeminal neuralgia (TN). Patients with tumor-related TN are typically treated by tumor resection. However, when craniotomy is not feasible, PBC may serve as a simple and effective method for pain relief. Currently, there is limited literature on the use of this technique in treating patients with tumor-related TN. In this study, we aim to evaluate the efficacy and safety of Dyna CT-assisted PBC in the treatment of tumor-related TN.
From January 2018 to December 2023, a total of 19 patients with tumor-related TN underwent Dyna CT-assisted PBC at our institution. The modified Barrow Neurological Institute Pain Intensity Grading Scale and sensory reduction scores were employed to assess treatment outcomes. A retrospective analysis was conducted on the clinical characteristics, surgical efficacy, postoperative complications, and follow-up results of all patients.
Immediate and complete pain relief was observed in 18 patients following PBC, with one patient experiencing delayed recovery. Follow-up periods ranged from 4 to 62 months, revealing only 4 patients with pain recurrence at the last follow-up, and tumor-related TN patients with involvement of Meckel's cave were more prone to recurrence. No severe complications occurred throughout the follow-up period. Although facial numbness was reported in all 15 patients, jaw weakness in 8 patients, and postoperative headache in 7 patients, these symptoms resolved within a short period. There were no statistically significant differences in postoperative facial numbness and jaw weakness between tumor-related TN patients with or without Meckel's cave involvement. However, patients with Meckel's cave involvement were more likely to experience postoperative headaches. Patient satisfaction scores indicated a significant improvement in postoperative quality of life.
For patients with tumor-related TN, when craniotomy is not feasible, Dyna CT-assisted PBC proves to be a safe and effective alternative treatment. Additionally, we observed varying postoperative clinical outcomes based on the different sites of tumor compression on the trigeminal nerve. Patients with tumor-related TN not involving Meckel's cave exhibited more enduring clinical efficacy compared to those with Meckel's cave involvement.
经皮球囊压迫术（PBC）已广泛应用于治疗三叉神经痛（TN）。肿瘤相关性 TN 患者通常采用肿瘤切除术进行治疗。然而，当开颅手术不可行时，PBC 可能成为一种简单有效的止痛方法。目前，关于该技术治疗肿瘤相关性 TN 患者的文献有限。本研究旨在评估 Dyna CT 辅助 PBC 治疗肿瘤相关性 TN 的疗效和安全性。
自 2018 年 1 月至 2023 年 12 月，我院共 19 例肿瘤相关性 TN 患者行 Dyna CT 辅助 PBC 治疗。采用改良巴罗神经研究所疼痛强度分级量表和感觉减退评分评估治疗效果。对所有患者的临床特征、手术效果、术后并发症和随访结果进行回顾性分析。
PBC 后 18 例患者即刻完全缓解疼痛，1 例患者延迟恢复。随访时间为 4 至 62 个月，末次随访时仅 4 例患者疼痛复发，且累及 Meckel 腔的肿瘤相关性 TN 患者更易复发。随访期间无严重并发症发生。尽管所有 15 例患者均出现面部麻木，但 8 例患者出现咀嚼肌无力，7 例患者出现术后头痛，这些症状均在短期内缓解。肿瘤相关性 TN 患者中，无论是否累及 Meckel 腔，术后面部麻木和咀嚼肌无力无统计学差异。然而，累及 Meckel 腔的患者更易发生术后头痛。患者满意度评分表明术后生活质量显著改善。
对于开颅手术不可行的肿瘤相关性 TN 患者，Dyna CT 辅助 PBC 是一种安全有效的治疗选择。此外，我们观察到根据三叉神经受压部位的不同，术后临床结局也存在差异。未累及 Meckel 腔的肿瘤相关性 TN 患者的临床疗效比累及 Meckel 腔的患者更持久。
