Percutaneous trigeminal ganglion compression for trigeminal neuralgia: Preliminary report

In 1978, the percutaneous trigeminal ganglion compression (PTGC) was initiated in the treatment of trigeminal neuralgia that was refractory to carbamazepine (Tegretol). The authors report 75 cases of trigeminal neuralgia treated by percutaneous trigeminal ganglion compression from June 2000 to Jan 2001. The operation was performed under general anesthesia with endotracheal intubation. Meckel's cave was cannulated with No.4 Fogarty catheter and the balloon was inflated for 60 to 80 seconds. Seventy (93%) patients were immediately relieved of their neuralgia after the first operation. Five patients underwent a second PTGC. Four patients were relieved of the symptom, but 1 patient was not improved. Three patients had postoperative wound hematoma. Twenty-one patients developed herpes simplex perioralis within the first few days of operation. There were two patients had transient 6th nerve palsy, the symptom was subsided within 3 months. There was no major surgical complication, no anesthetic complication and no death. The follow-up period was ranging from 3 months to 9 months, and no recurrent neuralgia was noted. We concluded that the PTCG procedure is easy to perform and requires a short operative time and a brief period of hospitalization. It is well tolerated by patients as a total pain-free experience. Morbidity is minimal, the rate of immediate pain relief rate is high and the rate of recurrence of neuralgia according to the reports in the literature, is not higher than with alternative procedures.