Efficacy of short time and repeated percutaneous microballon compression under the guidance of digital subtraction angiography in the treatment of patients with primary trigeminal neuralgia

Abstract

Objective To investigate the efficacy of short time and repeated percutaneous microballoon compression (PMC) under the guidance of digital subtraction angiography (DSA) in the treatment of trigeminal neuralgia (TN). Methods Twenty patients with TN aged ≥18 years old, both sexes, were collected in Pain Department of Qingdao Municipal Hospital from November 2017 to November 2018. All patients were divided into two groups (n=10): single time compression therapy group of PMC (group OPMC) and three times compression therapy group of PMC (group TPMC) according to random number table. The balloon was deflated and withdrawn after compressing the trigeminal nerve for 3 min in group OPMC; while alternating 3 cycles of 60 s inflation and 60 s deflation for trigeminal nerve compression in group TPMC. The short-form McGill pain questionnaire (SF-MPQ), visual analogue scale (VAS) and Pittsburgh sleep quality index (PSQI) were used for evaluation of pain degree and sleep quality before the treatment and 3 d, 10 d, 1 month, 3 months, 6 months, 12 months after the treatment. Barrow neurological institute (BNI) facial numbness scoring system was used to assess facial sensory impairment. Results Compared with pretreatment, the SF-MPQ, VAS and PSQI of two groups were significantly reduced at different time points after the treatment (all P 0.05). Compared with 3 d after the treatment, the BNI facial numbness scores of the two groups were significantly decreased at the other time points after the treatment (all P<0.05), and the BNI facial numbness scores of group TPMC were significantly lower than those of group OPMC (all P<0.05). All patients reported that their facial numbness had fully resolved in the two groups after one year. Conclusion Good effects can be achieved by the two different compression methods of PMC with the guidance of DSA/CT, but with slighter facial numbness with short time and repeated compression method. Key words: Trigeminal neuralgia; Trigeminal ganglion; Microballoon compression; Digital subtraction angiography