Abstract
Because of its convenience and safety, percutaneous balloon compression (PBC) has become a more popular remedy for trigeminal neuralgia (TN) recently. The objective of this study was to establish a nomogram that can be used to preoperatively prognosticate the likelihood of pain-free based on preoperative disease characteristics. Clinical data were collected from those TN cases who had undergone PBC during the period of 2015 and 2020 in Qingdao Municipal Hospital. We excluded the cases caused by space-occupying lesion or had undergone MVD, percutaneous glycerol rhizotomy (PGR), and glycerol rhizotomy (GR). A nomogram was established based on the results of multivariable logistic analysis. A receiver operating characteristic curve (ROC) analysis was applied to evaluate the reliability of models. The plotted decision curves were also used to assess the net benefit of nomogram-assisted decisions. Internal validation was performed using the ROC by bootstrap sampling. Finally, 16 cases and 69 cases were included into the ineffective and effective groups respectively. In the crude, adjust I and adjust II models, response to carbamazepine positively, the grade II or III compression severity score, and classical TN type were all considered to be significant predictors of pain relief (BNI grades I-III) at 3 months' follow-up. The AUC, accuracy, specificity, and sensitivity of the nomogram system were 0.83, 0.85, 0.75, and 0.87 respectively for predicting patient outcomes. The decision curves showed good performance for the nomogram system in terms of clinical application, while more research with validation in multiple, external independent patient populations is needed.
Highlights
Trigeminal neuralgia (TN) is a unilateral, sudden, recurrent pain in the distribution of the fifth cranial nerve
There was no significant differences in aspects of age, symptom duration, gender, affected side, trigeminal division, NRS, trigeminal cardiac reflex, facial numbness, and keratitis between the two groups
The TN type was classical in 62(89.9%) cases, which was significantly higher than that in the ineffective group (5, 31.2%)
Summary
Trigeminal neuralgia (TN) is a unilateral, sudden, recurrent pain in the distribution of the fifth cranial nerve. There is a wide range of medical and surgical treatments available for the TN[10, 5]. The microvascular decompression (MVD) has been widely accepted as an effective remedy for treatment of TN, it needs open-brain surgery and the mortality has been quoted as 0.22–2%[27, 11, 8, 23]. Percutaneous balloon compression (PBC) of a trigeminal ganglion (TG) is an acknowledged alternative with a relatively high pain relief rate, ranging from 70% to over 90%[25, 21, 18]. Because of its convenience and safety, PBC has become a more popular remedy for trigeminal neuralgia recently
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