Relations of balloon pressures with complications and recurrence in treatment of trigeminal neuralgia by percutaneous balloon compression
10.3760/cma.j.cn115354-20210607-00363
- VernacularTitle:PBC治疗三叉神经痛术中球囊压力与术后并发症、复发的关系研究
- Author:
Shaopeng PENG
1
;
Jianxiong LIU
;
Fei WANG
;
Hongxing ZHANG
;
Jian ZHANG
Author Information
1. 甘肃省人民医院神经外科，兰州 730000
- Keywords:
Trigeminal neuralgia;
Percutaneous balloon compression;
Balloon pressure;
Facial numbness;
Pain recurrence
- From:
Chinese Journal of Neuromedicine
2022;21(2):152-156
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the changing characteristics and stages of balloon pressures in treatment of trigeminal neuralgia by percutaneous balloon compression (PBC), and explore the relations of balloon pressures at different stages with postoperative facial numbness and pain recurrence.Methods:A prospective analysis was performed. Thirty-two patients with primary trigeminal neuralgia, admitted to our hospital from May 2019 to May 2020, were chosen. During surgery, a manometer was connected with computer manometry software to continuously monitor the balloon pressure changes; pear-shaped stage and maintenance stage were named during the balloon pressure changes. The facial numbness occurrence and pain recurrence were assessed by Barrow Institute of Neurology (BNI) facial numbness and pain intensity scales. Robust evaluation method referred to American Institute for Clinical and Laboratory Standardization (CLSI) C28-A2 document was used to determine the reference ranges of balloon pressures at the pear-shaped stage, maintenance stage and whole-process stage (pear-shaped stage+maintenance stage). Spearman rank correlation test was used to analyze the correlations of balloon pressures at the pear-shaped stage, maintenance stage and whole-process stage with facial numbness 24 h and 12 months after surgery, and pain recurrence 6 and 12 months after surgery.Results:Among the 32 patients, pain relief was found in 31 patients and lateral numbness was found in 30 patients 24 h after surgery. Pain recurred 12 months after surgery in 2 patients. The reference ranges of pressure at pear-shaped stage, maintenance stage and whole-process stage were (157.2-128.5) kPa, (136.10-117.9) kPa and (141.9-119.9) kPa, respectively. The pressures at pear-shaped stage, maintenance stage and whole process stage were positively correlated with facial numbness 24 h and 12 months after surgery ( P<0.05); there were negative correlations between pressures at pear-shaped stage and whole-process stage and pain recurrence 6 months after surgery ( P<0.05); pressures at pear-shaped stage, maintenance stage and whole-process stage were negatively correlated with pain recurrence 12 months after surgery ( P<0.05). Conclusion:The lower the balloon pressure during PBC, the more likely it would have pain recurrence after surgery; and the higher the pressure, the more likely it would have facial numbness after surgery; the efficacy of PBC can be maximized when the balloon pressures maintains at adequate ranges ([157.2-128.5] kPa at the pear-shaped stage, [136.1-117.9] kPa at the maintenance stage and [141.9-119.9] kPa at the whole-process stage).
