Percutaneous balloon compression (PBC) of trigeminal ganglion for recurrent trigeminal neuralgia after microvascular decompression (MVD).

Background: Although microvascular decompression (MVD) has become the best surgical treatment for trigeminal neuralgia, it does not achieve 100% cure rate. Re-exploration of the posterior fossa may carry increased risk over first-time MVD and is not always successful, so other treatments are needed.

Objective: In this study, we evaluate the effectiveness of the patients with recurrent trigeminal neuralgia after MVD treated with percutaneous balloon compression (PBC).

Methods: The clinical data of 52 recurrent trigeminal neuralgia patients after MVD who underwent PBC between November 2007 and March 2012 were retrospectively reviewed and analyzed.

Results: After the PBC, 50 patients (96.2%) experienced immediate pain relief; 1 patient had occasional pain, and did not require medication; and 1 patient had no pain relief. The total efficiency was 98.1%. With a mean length of follow-up of 37.6 months, ranging from 12 to 64 months after surgery, 43 (82.7%) patients remained pain-free, 4 patients (7.7%) had mild recurrence, and 3 patients (5.8%) had severe recurrence. The mean time to recurrence was 25.1 months (5-60 months). PBC was repeated a second time in three patients, a third time in one patient. Postoperative complications included facial numbness in 51 patients (98.1%), masseter muscle weakness in 31 patients (59.6%), paresthesia in 5 patients (9.6%), and diplopia secondary to abducens nerve palsy in 1 patient (1.9%). None of the patients had serious surgical morbidities.

Conclusions: PBC is a minimally invasive, safe and effective procedure which can be regarded as an optimized choice for recurrent trigeminal neuralgia after MVD.