Percutaneous Balloon Compression Of Semilunar Ganglion And Microvascular Decompression Clinical Effect Observation Of Treating Primary Trigeminal Neuralgia

OBJECTIVE To investigate the clinical efficacy of percutaneous balloon compression of semilunar ganglion(PBC)and microvascular decompression(MVD)in the treatment of primary trigeminal neuralgia(TN),and to provide guidance for the individualized surgical treatment of patients with primary trigeminal neuralgia(TN).Methods A retrospective analysis of anhui anqing hospital affiliated to medical university in October 2018 to March 2020,the clinical data of 64 patients with primary trigeminal neuralgia,33 cases of primary trigeminal neuralgia were treated by percutaneous puncture and ganglion balloon compression decompression group(PBC),the other 31 patients were treated by microvascular decompression(MVD),the two kinds of operation scheme of two groups of patients with postoperative line BNI score,their postoperative pain was observed,the duration of surgery and hospitalization time and cost comparison,and analysis of two different postoperative complications.Results In the microvascular decompression group,27 patients had no obvious pain immediately after surgery,2 patients had mild pain after surgery,and 1 patient had severe pain before surgery,and the pain was significantly reduced after surgery.All these 30 patients did not need other adjuvant treatment to relieve pain after surgery.That is,there were 30 effective cases and 1 invalid case.Postoperative temporary hearing impairment occurred in 1patient,hearing loss in 2 patients,tinnitus in 2 patients,hearing of 1 patient with temporary hearing impairment recovered to the preoperative level on the second day after surgery,hearing of 1 patient with hearing loss recovered to the preoperative level 3 months after surgery,tinnitus symptoms disappeared in 1 patient 3 months after surgery,and tinnitus symptoms remained unchanged in the other 2 patients.One patient developed anaesthesia and numbness in the trigeminal nerve distribution area on the affected side,and the numbness relieved 10 days after surgery.There were no intracranial hematoma and infection cases,but almost most patients developed varying degrees of dizziness,pain,nausea and vomiting after surgery,and the symptoms disappeared after symptomatic treatment in hospital.In the percutaneous balloon compression group of semilunar ganglion,there were 26 patients with complete loss of postoperative pain,and 6 patients were effective,among which 4 patients did not need postoperative drug therapy,and 2 patients needed oral drug adjuvant therapy.That is,32 cases were effective and 1 case was invalid.Among them,15 patients developed relatively obvious facial numbness,and most of them recovered within 6 months to 1 year after operation.One patient developed contralateral masseter weakness,which recovered 2 months after surgery.One patient developed herpes on the corner of the mouth,which was cured one week after operation.There were no cases of intracranial hematoma and infection.The pain relief rates of the PBC group and the MVD group were 96.97% and 96.77%,respectively,and there was no significant difference between the two groups(P > 0.05).The hospitalization cost of the MVD group was higher than that of the PBC group [(31171.6±3356.4)yuan vs(20319.5±1741.4)yuan],and the duration of operation and hospitalization of the MVD group was longer than that of the PBC group [(182.6±22.2)minutes vs(37.6±8.0)minutes]and [(17.4±2.7)days vs(7.0±1.4)days],with statistical significance(P < 0.05).The total incidence of complications in the PBC group was higher than that in the MVD group(51.5%vs 19.4%),and the difference was statistically significant(P < 0.05).Conclusion Both percutaneous balloon compression of semilunar ganglion and microvascular decompression have significant efficacy in the treatment of primary trigeminal neuralgia.Balloon compression has the advantages of low risk,minor trauma,short course of treatment,and more economic.However,the overall incidence of postoperative complications of microvascular decompression is relatively low.Microvascular decompression is preferred for patients with trigeminal neuralgia who are shown to be responsible for vascular compression,have no contraindications to craniotomy and do not refuse craniotomy.For patients with poor physical conditions,who are unwilling to accept or cannot tolerate craniotomy,and for patients with recurrence after MVD surgery,percutaneous puncture and balloon compression of semilunar ganglion with short operation and hospital stay,small trauma,and avoidance of craniotomy risk is more appropriate.