Role of 3D printed guide plate in percutaneous balloon compression for drug-refractory trigeminal neuralgia
Objective To explore the role of 3D printed guide plate in percutaneous balloon compression(PBC)for the treatment of medically refractory trigeminal neuralgia(TN).Methods Clinical data of 39 patients with drug-refractory TN treated with PBC from October 2020 to October 2023 at the Department of Neurosurgery of the First Affiliated Hospital of Shihezi University were retrospectively collected.Among them,16 patients chose to use 3D-printed guides to assist PBC(experimental group);23 patients refused to use 3D printed guides and were punctured with bare hands under digital subtraction angiography guidance(control group).The number of patent foramen ovale punctures,puncture time,total procedure duration,dose of contrast used,duration of balloon compression,pear shape formation of balloon,postoperative Barrow Neurological Institute(BNI)pain intensity score,and the occurrence of procedure-related complications were compared between the two groups.Results All 39 patients underwent successful operation.Compared with the control group,the study group had fewer intraoperative punctures of the foramen ovale[1(1,2)vs.2(2,3)],shorter puncture time[1.8(1.0,3.8)min vs.6.0(3.0,16.0)min],and shorter total operative time[29.6±3.9 min vs.46.3±15.1 min],and the differences were statistically significant(all P＜0.001).The success rate of"pear-shaped"balloon[75.0％(12/16)vs.60.9％(14/23)]and the success rate of"pear-shaped"balloon at one time[62.5％(10/16)vs.13.0％(3/23)]were both higher.However,the difference in the success rate of"pear-shaped"balloon was not statistically significant(P=0.495),while the difference in the success rate of"pear-shaped"balloon at one time was statistically significant(P=0.002).There were no serious postoperative complications in either group,and the difference in the proportion of facial numbness,difficulty in mastication or herpes was not statistically significant in the study group except for the proportion of swelling at the puncture site,which was smaller than that in the control group[12.5％(2/16)vs.56.5％(13/23),P=0.008].The difference in the BNI score between the two groups at 3 months postoperatively was not statistically significant(P=0.922).Conclusion PBC assisted with 3D printed guide plate for drug-refractory TN can effectively improve the success rate of puncture,shorten the operation time and reduce the risk of surgery.
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