Effectiveness of Percutaneous Balloon Compression for Trigeminal Neuralgia: A Retrospective Analysis

Background: Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain within the distribution of one or more branches of the trigeminal nerve. Pain may be triggered by minor triggers; some episodes may occur without an apparent trigger. Percutaneous balloon compression (PBC) of trigeminal ganglion has been found to be an excellent procedure in giving patients relief from symptoms. The procedure can be repeated in case of recurrence of pain. Aims: This study aimed to assess the degree of pain relief and to evaluate the improvement in quality-of-life in patients undergoing PBC. Settings and Design: We describe the successful management of pain in 25 cases of TN with PBC. The procedures were done in a tertiary care hospital, in Bengaluru from the period of January 2022 to April 2024. Methodology: The procedure was undertaken under general anaesthesia, under fluoroscopic guidance. In all patients, successful inflation of the balloon (4 Fr Fogarty catheter) was done for 90 s with 0.7 mL of dye (omnipaque™). The extent of the pain score was evaluated using the Barrow Neurological Institute (BNI) Pain scale. Assessment of quality of life was done by using Penn Facial Pain Scale-Revised (Penn FPS-R). Statistical Analysis: The IBM SPSS version 23.0 software was used for statistical processing. BNI Score was evaluated using a nonparametric test. Penn FPS-R was evaluated by parametric test (paired t -test). Results: In a total of 25 patients postprocedure BNI score is reduced from IV to I-IIIa. All the patients reported improved quality of life on assessment with Penn FPS-R after 6 months of the procedure. Conclusions: PBC offers an excellent modality of pain relief in patients with resistant TN with previous failed conservative/interventional pain management options, even in the elderly who carry a high risk of complications with microvascular decompression.