Percutaneous balloon compression for primary trigeminal neuralgia in patients older than 80 years

Abstract

Background: It has been demonstrated that the incidence of trigeminal neuralgia in elderly patients is higher and thus, neurosurgeons often encounter elderly patients with this disorder. However, for those with poor basic condition, the optimal surgical treatment remains controversial. In this study, the authors aimed to evaluate the safety and efficacy of percutaneous balloon compression (PBC) for primary trigeminal neuralgia in elderly patients older than 80 years. Methods: From September 2009 to March 2013, a total of 68 patients older than 80 years underwent PBC, and a retrospective study of the clinical data of these patients was performed. Results: After PBC, pain relief was immediate in 66 (97.0 %) patients, 1 (1.5 %) patient had no pain relief, and 1 (1.5 %) patient had some pain that could be controlled with medication. With a mean length of follow-up of 40.1 months, ranging from 24 to 66 months after surgery, 55 (80.9 %) patients were still pain free. Of the 11 patients with recurrence, 9 cases had mild recurrence and 2 cases suffered severe recurrence. The mean time to recurrence was 18.9 months (1-64 months). Postoperative morbidity included common side effects such as facial numbness in 66 (97.1 %) patients, masseter muscle weakness in 19 (27.9 %) patients, paresthesia in 7 (10.3 %) patients, and diplopia secondary to abducens nerve weakness in 1 (1.5 %) patient. No corneal anesthesia, subarachnoid hemorrhage, or other serious surgical complications occurred in this study. Conclusions: In this study, the authors reviewed data on a cohort of patient older than 80 years. The PBC procedure has advantages in that it is minimally invasive, safe, effective, and could be performed under general anesthesia. This makes it an optimized choice for elderly patients.