Study On The Correlation Between Balloon Pressure And Reconstruction Parameters Of Foramen Ovale And Meckel’s Cave During PBC

Aim:To investigate the correlation between balloon pressure and preoperative anatomical parameters of foramen ovale and Meckel’s cave during percutaneous balloon compression（PBC）,and to provide a basis for predicting balloon pressure during PBC.Methods:Twenty-eight patients with primary trigeminal neuralgia who received PBC surgery in the Department of Pain,Third Xiangya Hospital,Central South University from November 2020 to May 2021 were selected.Preoperative thin-layer THREE-DIMENSIONAL reconstruction of the skull base was performed.At the same time,the high resolution MRI of skull base was completed,and the Meckel’s cave was reconstructed and its volume was calculated.The balloon pressure was continuously monitored with a disposable portable manometer.Postoperative pain relief was assessed by visual analog scale（VAS）immediately after surgery,1 day after surgery,before discharge,1 month,3 months,6 months,and 12months.Pain recurrence was assessed by the Barrow Neurological Institute（BNI）pain Score,and numbness was assessed by the BNI numbness score.The relationship between postoperative efficacy of PBC,facial numbness and intraoperative pressure was analyzed,and the correlation between intraoperative balloon pressure of PBC and anatomical parameters of foramen ovale and Meckel’s cave volume was tested by Pearson and Spearman correlation analysis.Results:1.The balloon filling pressure（P₀）during PBC was 165±25kpa,and the balloon pressure(P₁₂₀)after 120 s of compression was 137±20kpa.The immediate and obvious relief rate of postoperative pain was 96.4%.2.Within a certain pressure range,the degree of facial numbness after PBC was not significantly correlated with balloon pressure.3.The balloon filling pressure（P₀）during PBC was positively correlated with the length and diameter of foramen ovale（r=0.44,P=0.024）,and negatively correlated with the volume of Meckel’s cave before PBC（r=-0.55,P=0.006）;The degree of balloon filling was positively correlated with the volume of Meckel’s cave（r=0.54,P=0.009）,Satisfy V₀=0.443V+0.42（R2=0.196,P=0.034）.Conclusion:During PBC,the balloon filling pressure is related to the maximum cross-sectional diameter of the foramen ovale and the volume of Meckel’s cave,and the degree of balloon filling is related to the volume of Meckel cave.The reconstruction of the foramen ovale and Meckel’s cave through preoperative imaging data has a certain predictive value for the balloon filling pressure and the degree of balloon filling during PBC.