Comparison Of Neuronavigation Assisted Percutaneous Balloon Compression And Microvascular Decompression

Objective: To explore the clinical efficacy and complications of navigation-assisted percutaneous puncture of the trigeminal semilunar balloon compression(PBC)and microvascular decompression(MVD).Methods : A retrospective analysis of 118 patients with trigeminal neuralgia from January 01,2014 to November 01,2018 in the Department of Neurosurgery,affiliated Hospital of Guilin Medical College was divided into 26 patients in the PBC group and 92 patients in the MVD group according to different treatment methods.Group design was performed to control for potential biases.Finally,18 patients in the PBC group and 36 patients in the MVD group were included in the study.The operation time,hospitalization time,immediate postoperative efficacy,recurrence rate and related complications were compared between the two groups.Results: The effective rates of MVD group and PBC group were 97.2% and 94.4%,the cure rates were both 94.4%,there was no significant difference between the two groups(P>0.05).The operation time and length of hospital stay in the PBC group were significantly shorter than those in the MVD group(20.6±10.1min vs 116.0±32.6min;2.4±1.5d vs 11.6±3.2d,P<0.05).Facial numbness,perioral herpes,trigeminal nerve suppression and masticatory muscle weakness in the PBC group were significantly more than those in the MVD group(94.4%vs2.8%,28.8%vs2.8%,38.9% vs2.8%,28.8% vs0%,P<0.05),it is statistically significant.peripheral facial paralysis,suffering hearing loss,intracranial infection in the PBC group was less than those in the MVD group(5.6%vs8.3%,0vs2.8%,0% vs2.8%,P>0.05),there was no significant difference.No intracranial hemorrhage and diplopia occurred in either group.Conclusions: Both MVD and PBC are effective in treating TN,various assistive techniques also make the treatment more effective.MVD has a high effective rate,fewer complications such as Facial numbness,perioral herpes,trigeminal nerve suppression reaction and masticatory muscle weakness.PBC has a high cure rate,high safety,small trauma,short operation time and short hospital stay.There are fewer complications such as intracranial infection,intracranial hemorrhage and cerebrospinal fluid leakage.In conclusion,MVD treatment of trigeminal neuralgia is the first choice for radical surgery to remove the cause.For patients with poor general condition,especially patients who have multiple systemic diseases and cannot tolerate craniotomy,it is a wise choice to use navigation assisted PBC.