Knowing the Action of Percutaneous Balloon Compression (PBC)

Sahabat Hermina, Percutaneous Balloon Compression (PBC) is a minimally invasive medical procedure used to treat severe facial pain due to trigeminal neuralgia. Trigeminal neuralgia is a chronic nerve pain condition that causes severe pain on one side of the face, often described as feeling like an electric shock. Pain is triggered by things that should not cause pain. Such as touching, eating, drinking, talking, smiling, washing your face, brushing your teeth and being exposed to cold air. This procedure aims to relieve pain by compressing the trigeminal nerve at the base of the skull using a small balloon that is inserted with a special catheter through the skin of the cheek.

PBC is usually recommended for patients whose pain is not relieved by medication, and are not suitable for more invasive surgery. The main indications for PBC include:

• Trigeminal neuralgia unresponsive to medical therapy.
• Patients with health conditions that do not allow for major surgical procedures.
• Patients who experience significant side effects from medical treatment.
• The patient failed surgery or radiofrequency treatment.

Procedure

PBC is performed using minimally invasive techniques under the guidance of X-Ray fluoroscopy (C-arm) or CT scan imaging. The following are the general stages in the PBC procedure:

• Patient Preparation: The patient is given general anesthesia so that there is no pain during the procedure.
• Access to Foramen Ovale: The surgeon inserts a needle through the skin on the cheek, next to the corner of the lip into the foramen ovale, a hole at the base of the skull where the trigeminal nerve exits.
• Balloon Placement: Once the needle reaches the correct location, a small balloon catheter is inserted through the needle. This balloon is then inflated to compress the Gasserian ganglion, which is part of the trigeminal nerve.
• Balloon Complications: The balloon is left to press against the ganglion for say 1.5 minutes to achieve the desired effect.
• Equipment Lifting: After the specified time, the balloon is deflated and removed along with the needle.
• Recovery: The patient is then monitored for some time before being allowed to go home.

Profit   

• Minimally Invasive: PBC is a procedure that does not require open surgery so it reduces risk and has a faster recovery time.
• High Effectiveness: This procedure has a high success rate in relieving pain in patients with trigeminal neuralgia.
• Faster Preparation for Action.
• Fast Recovery Time: Post-operative care or monitoring takes no longer than 2 hours to 1 day and immediately returns to normal activities.

Risks and Complications

Like other medical procedures, PBC also has risks and potential complications, including:

• Infection: Although rare, infection can occur at the needle insertion site.
• Hematoma: Bleeding around the compression area can cause a hematoma.
• Loss of Sensation: Some patients may experience numbness or loss of sensation in the facial area.
• Pain Relapse: Pain may return after several months or years, and a repeat procedure may be necessary.

So, Percutaneous Balloon Compression (PBC) is an effective and minimally invasive therapy option for treating trigeminal neuralgia. With a relatively simple procedure and quick recovery time, PBC provides a good alternative for patients who cannot undergo more invasive surgery or are unresponsive to medical treatment. However, as with all medical procedures, it is important to weigh the risks and benefits and consult a specialist who is experienced in performing this procedure. Stay healthy.

 

Reference

Burchiel, K. J. (2003). "Microvascular Decompression and Other Surgical Management of Trigeminal Neuralgia". Neurosurgery Clinics of North America.

Kanpolat, Y., Savas, A., Ugur, H. C., & Elhan, A. H. (2001). "Percutaneous Controlled Radiofrequency Rhizotomy in the Treatment of Idiopathic Trigeminal Neuralgia: 25-Year Experience with 1,600 Patients". Neurosurgery.

Sweet, W. H., & Wepsic, J. G. (1974). "Controlled Thermocoagulation of Trigeminal Ganglion and Rootlets for the Relief of Tic Douloureux". Journal of Neurosurgery.

Zakrzewska, J. M., & McMillan, R. (2011). "Trigeminal Neuralgia: The Diagnosis and Management of This Excruciating and Poorly Understood Facial Pain". Postgraduate Medical Journal.