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Percutaneous balloon compression for trigeminal neuralgia: a how I do it

  • How I Do it - Functional Neurosurgery - Pain
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Abstract

Background

Surgical treatments for trigeminal neuralgia may include percutaneous techniques including the balloon compression technique. We present here a simple, effective, and safe adaptation of the historical technique described by Mullan in 1978.

Method

Our procedure is performed in a bi-plane neuro-radiology room. During general anesthesia, 14-G needle is guided under radioscopy to foramen ovale. The 3-F embolectomy catheter is then inserted and inflated with contrast for a period of 2 min 15 s.

Conclusion

Our technique, performed entirely under bi-plane fluoroscopy, allows a quicker and more precise surgery and avoids errors in guiding the catheter that can result serious injury.

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References

  1. Alvernia J, Wydh E, Simon E, Sindou M, Mertens P (2009) Microsurgical anatomy of the transoval percutaneous route to the trigeminal cave and the trigeminal ganglion. Neurochirurgie 55(2):87–91

    Article  CAS  PubMed  Google Scholar 

  2. Bernard F, Mercier P, Sindou M (2019) Morphological and functional anatomy of the trigeminal triangular plexus as an anatomical entity: a systematic review. Surg Radiol Anat 41(6):625–637

    Article  PubMed  Google Scholar 

  3. Brown JA, Preul MC (1988) Trigeminal depressor response during percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. Neurosurgery 23(6):745–748

    Article  CAS  PubMed  Google Scholar 

  4. Chen J-F, Tu P-H, Lee S-T (2012) Repeated percutaneous balloon compression for recurrent trigeminal neuralgia: a long-term study. World Neurosurg 77(2):352–356

    Article  PubMed  Google Scholar 

  5. Fan X, Xu F, Ren H, Lu Z, Bu H, Ma L, Kong C, Wang T (2021) The analysis of percutaneous balloon compression on efficacy and negative emotion in the treatment of recurrent trigeminal neuralgia after surgical procedures. Pain Physician 24(8):E1255–E1262

    PubMed  Google Scholar 

  6. Härtel F (1914) Uber die intracranielle Injektions behandlung der trigeminus- neuralgie. Med Klin 10:582

    Google Scholar 

  7. Keravel Y, Gaston A, Ciampi de Andrade D, Mencattini G, Le Guérinel C (2009) Traitement de la névralgie trigéminale par la compression par ballon. Neurochirurgie 55(2):197–202

    Article  CAS  PubMed  Google Scholar 

  8. Mullan S, Lichtor T (1983) Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. J Neurosurg 59(6):1007–1012

    Article  CAS  PubMed  Google Scholar 

  9. Omeis I, Smith D, Kim S, Murali R (2008) Percutaneous balloon compression for the treatment of recurrent trigeminal neuralgia: long-term outcome in 29 patients. Stereotact Funct Neurosurg 86(4):259–265

    Article  PubMed  Google Scholar 

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Acknowledgements

Thanks to Maxime Ybert for his help in making the video.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, CHU Caen, Avenue de La Côte de Nacre, 14000, Caen, France

    Arthur Leclerc & Evelyne Emery

  2. Medical School, Université Caen Normandie, 14000, Caen, France

    Arthur Leclerc & Evelyne Emery

  3. Department of Neuroradiology, CHU Caen, 14000, Caen, France

    Mohamad Fadi Salkine

  4. INSERM, UMR-S U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), GIP Cyceron, 14000, Caen, France

    Evelyne Emery

Authors
  1. Arthur Leclerc
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  2. Mohamad Fadi Salkine
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  3. Evelyne Emery
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Corresponding author

Correspondence to Arthur Leclerc.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional Ethics Committee of Caen University Hospital (Caen, France) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Patient consent

Informed consent was obtained from the patient included in the study.

Conflict of interest

The authors declare no competing interest.

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Key points

• Installation in hyperextension is essential to properly locate the foramen ovale.

• The balloon must be properly prepared to avoid air bubbles that could underestimate the filling of the balloon.

• Systematic administration of atropine before dural perforation prevents cardiac consequences.

• Mixing saline solution with iohexol allows a better balloon filling.

• From the front, the medial border of the foramen ovale should be aimed for optimal penetration of the trocar.

• We advise to slightly remove the trocar before balloon inflation to avoid balloon perforation.

• In case of balloon perforation, the procedure can be repeated with a new balloon.

• Compression for too long can lead to sequential and disabling neuropathic pain.

• In case of painful recurrence, a second procedure can be performed.

This article is part of the Topical Collection on Functional Neurosurgery – Pain.

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Leclerc, A., Salkine, M.F. & Emery, E. Percutaneous balloon compression for trigeminal neuralgia: a how I do it. Acta Neurochir 164, 2939–2943 (2022). https://doi.org/10.1007/s00701-022-05242-6

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  • DOI: https://doi.org/10.1007/s00701-022-05242-6

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