Percutaneous ballon compression for recurrent TN —a retrospective study of 33 cases
Authors: Feng Dongwei , Zhang Yaxin , Li Dong , Wang Kang , Yang Fan , Ding Jianan , Wu Weize , Wang Yunhe , Jia heping 
Published: August 2023

Objective
To investigate the clinical efficacy of percutaneous microballoon compression in the treatment of recurrent TN.
Methods
The retrospective study including 33 patients who underwent percutaneous microballoon compression for the treatment of recurrent TN from March 2019 to May 2022. There were 11 male and 22 females with a mean age of 70.9 years. The Pain side includes left side in 10 cases and right side in 23 cases. The duration of illness ranged from 2 to 20 years, with a median duration of illness of 5 years. The interval between this operation and the last operation was (12–80) months, with an average of 36.6 ± 18.6 months. Postoperative pain recurrence and facial numbness were assessed according to the Barrow Neurological Institute (BNI) pain score. Patients' anxiety and sleep status during follow-up were assessed according to self-rating anxiety scale (SAS) and Pittsburgh sleep quality index (PSQI).
Results
All patients (33 cases) were followed up for 12–38 months, with an average follow-up time of 23 months. The pain relief rate 24 hours after surgery was 93.9%, and 2 patients with pain grade III were given drug treatment for pain relief. There were 32 cases of facial numbness in the affected side, and the facial numbnessnumbness grade of BIN at 12 months was II or less. Twenty patients developed varying degrees of masticatory muscle weakness, which gradually recovered after 2 to 10 months. Four patients developed perioral herpes simplex and were cured after giving antiviral drugs. One patient developed ocular discomfort, which improved after 2 weeks. One patient had recurrence of pain at 6 months, which was relieved by oral medication. There were no serious complications such as hearing impairment, intracranial hemorrhage and keratitis. According to the pain score of the Institute of Neurology (BNI), the preoperative pain score was 3.00 and 0.21 ± 0.60 at the last follow-up, and there was a significant difference in pain scores at different periods (P < 0.001). Preoperative moderate to severe anxiety was 81.8% (27/33), and moderate to severe anxiety was 15.2% (5/33) at the last follow-up, and the differences were statistically significant compared with preoperative (P < 0.001). Preoperative sleep quality was poor in 54.5% (18/33). The number of sleep at the last follow-up was 9.1% (3/33) worse, and the differences were statistically significant compared with those before surgery (P < 0.001). Poor sleep quality was observed in 54.5% (18/33) before surgery. The difference in the number of sleep at the last follow-up was 9.1% (3/33), and the differences were statistically significant compared with those before surgery (P < 0.001).
Conclusion
PBC is a practical and effective method for the treatment of recurrent TN. It not only has obvious analgesic effect, but also improves the anxiety and sleep disorder of patients. The rich experience of surgeons and meticulous intraoperative operation help to reduce the related complications and improve the clinical efficacy.