Compression of gasserian ganglion and trigeminal root with balloon in the treatment of trigeminal neuralgia: prospective study of 40 patients

THESES

COMPRESSION OF GASSERIAN GANGLION AND TRIGEMINAL ROOT WITH BALLOON IN THE TREATMENT OF TRIGEMINAL NEURALGIA: PROSPECTIVE STUDY OF 40 PATIENTS (ABSTRACT)^*. THESIS. SÃO PAULO, 2000.

HEIDER LOPES DE SOUZA^**

Forty patients presenting trigeminal neuralgia underwent Gasserian ganglion and trigeminal roots compression with Fogarty's balloon are presented. The natural history, the clinical presentation and the demographic aspects of the patients were similar to that described in the literature. Fifty procedures were performed; 30 patients underwent one compression and nine, two. In one patient the procedure was bilateral.

The follow-up ranged from six to 48 months. One compression was effective in 37 (90.26%) hemifaces and the second procedure alleviated pain in nine (100%) patients. There were only minor immediate and late complication rates. Recurrence of pain occurred in six (15%) patients during the 48 months follow-up period; four, during the first 24 months; one, at the 36^th month, and the remainder at the 42^nd month.

Two (5%) patients did not present relief of pain and underwent a second procedure during the first 24 hours after the first one and had total pain relief. Two (5%) other patients presented partial pain relief; one did not agree with the second procedure and the other was operated six months after the first surgery.

Compression time, along with balloon shape and volume were analyzed. The first compression lasted 60 seconds and the second, 120 seconds. During the procedure, pear or hourglass shape of the balloon were induced. The hemifacial numbness was mild in most patients; it was moderate but not disagreeable when the compression time was longer or when the balloon had an hourglass shape. After the second compression all patients presented intensification of the hemifacial numbness.

It was concluded, then, that the Gasserian ganglion compression with balloon is efficient, the complication rate is low and the procedure can be performed under light general anesthesia, as the cooperation of the patient is not needed. There was a tendency to get better results in patients with an hourglass shape balloon achievement. When a pear shape balloon was achieved a motor mastigatory deficit and facial numbness were observed. The maximum follow-up period was 48 months and the recurrence rate was 15%.

KEY WORDS: pain, trigeminal neuralgia, surgery, balloon compression.

*

Compressão do gânglio de Gasser e da raiz trigeminal com balão no tratamento da neuralgia do nervo trigêmeo: estudo prospectivo de 40 doentes (Resumo). Tese de Doutorado, Universidade Federal de São Paulo (Área de concentração: Neurocirurgia). Orientador: Manoel Jacobsen Teixeira. Co-orientador: Oswaldo Inácio de Tella Júnior.

**

Address: Avenida Rodrigues Alves 875, 59020-100 Natal RN , Brasil.

Publication Dates

• Publication in this collection
  28 Nov 2001
• Date of issue
  Dec 2001