Percutaneous Balloon Compression Guided by a Compression-Time Effect in Trigeminal Nerve Branches

Background: Percutaneous balloon compression (PBC) is an important treatment for trigeminal neuralgia (TN). Establishing the duration of balloon compression involves a tradeoff between outcome and postoperative complications. We aimed to explore the effect of the duration of balloon compression on the numbness response in areas innervated by the branches of the trigeminal nerve. Methods: Thirty-three patients with TN were included as an exploratory cohort, and the response area and compression time to the onset of facial numbness were recorded intraoperatively. Seventy-six patients with TN were then randomly divided into experimental (EG) and control groups (CG) for validation. The EG was treated with balloon compression times adjusted to reflect the compression-time effect observed in the initial investigation, whereas the CG was treated with a standardized compression time of 180 s. Patients were followed up postoperatively for pain relief and facials to verify the reliability of the effect. Results: We found that the mean compression time to numbness in the region innervated by the ophthalmic meridian (V1) was 89.09 ± 8.99 s; by V1 and the maxillary nerve (V2), 123.52 ± 7.97 s; and by V1, V2, and the mandibular nerve (V3), 181.33 ± 10.29 s. All 76 patients used to verify the effect had complete relief of pain, and the EG had significantly less numbness than the CG. Conclusion: In PBC, with the extension of balloon compression time, the numbness response of each branch of the trigeminal nerve appears in a certain order. This effect can guide PBC in mitigating complications while ensuring efficacy.