Outcomes of Treatment for Elderly Patients With Trigeminal Neuralgia: Percutaneous Balloon Compression Versus Microvascular Decompression

J Craniofac Surg. 2020 Oct;31(7):e685-e688. doi: 10.1097/SCS.0000000000006544.

Abstract

Objective: The study aimed to evaluate the surgical outcomes of percutaneous balloon compression (PBC) and microvascular decompression (MVD) in the treatment of elderly patients with trigeminal neuralgia (TN).

Methods: A total of 30 patients who underwent PBC surgery (PBC group) and 30 patients who received MVD surgery (MVD group) were included. The treatment efficacy, Barrow Neurological Institute (BNI) pain intensity score, inflammatory response, the rates of complication and recurrence were analyzed respectively.

Results: The total efficacy was 93.33% in the PBC group and 90.00% in the MVD group (P > 0.05), respectively. The pain relief rate was 90.00% and 86.67% after PBC and MVD surgery, respectively (P > 0.05). The levels of IL-1β, TNF-α, and IL-6 were significantly decreased at post-operative 3 days and 5 days compared with pre-operation in the 2 groups (P < 0.05). The post-operative complication rates regarding masticatory muscle weakness and facial numbness in the PBC group were higher than MVD group (P < 0.05). Nevertheless, the incidences of herpes simplex and keratohelcosis were similar between the 2 groups (P > 0.05). The recurrence rates were also similar between the 3 groups (P > 0.05).

Conclusion: Percutaneous balloon compression and MVD are effective in the treatment for elderly TN, which can effectively improve the post-operative cure rate of pain prognosis and reduce the inflammatory response. However, PBC is a minimally invasive, safe and effective method for patients in poor general condition and refused treatment with craniotomy.

MeSH terms

  • Aged
  • Balloon Occlusion* / adverse effects
  • Balloon Occlusion* / methods
  • Humans
  • Hypesthesia / etiology
  • Microvascular Decompression Surgery* / adverse effects
  • Microvascular Decompression Surgery* / methods
  • Pain / etiology
  • Pain Management
  • Pain Measurement
  • Postoperative Complications
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • Trigeminal Neuralgia / surgery*