Percutaneous Balloon Compression and Percutaneous Radiofrequency Ablation in Patients with Idiopathic Trigeminal Neuralgia: Management Outcome

Abstract

Background: Trigeminal neuralgia is a chronic pain syndrome characterized by paroxysmal, shock-like, stabbing, recurrent episodes of pain localized in the distribution area of one or more branches of the trigeminal nerve. The Initial approach for treating trigeminal neuralgia consists of pharmacological therapy. Many patients experience initial pain relief with pharmacological therapy; however, most of those patients eventually undergo surgery. Patients and Methods: In this descriptive prospective study, we evaluate the efficiency and safety of percutaneous balloon compression (PBC) and percutaneous radiofrequency ablation (RFA) in treating patients with typical idiopathic trigeminal neuralgia. This study includes 21 patients (divided into two groups, PBC = 15 patients and RFA = six patients) who met our inclusion and exclusion criteria, from May 2018 to April 2019, with a follow-up period of six months. Results: At one month postoperative follow-up, all patients in both groups were pain-free. At six months postoperative follow-up, in group 1 (PBC), 14 (95.24%) patients were pain-free, while in group 2 (RFA) all patients remained pain-free. The most common encountered postoperative complications are masticatory muscles weakness (Four patients in PBC group, and one patient in RFA group) and facial hypothesia (12 patients in PBC group and four patients in RFA group). Conclusions: In our study, patients with trigeminal neuralgia were not controlled by drug treatment, but percutaneous balloon compression and percutaneous radiofrequency ablation proved to be very effective treatment options, with no major complications.