经皮球囊压迫三叉神经节治疗三叉神经痛对患者眼表的影响

doi:10.3969/j.issn.1006-5725.2025.02.009

Abstract

Abstract:

Objective To investigate the effect of percutaneous balloon compression on the ocular surface in the treatment of trigeminal neuralgia （TN）. Methods A total of 30 patients （60 eyes） diagnosed with TN who underwent parallel balloon compression surgery from May 2023 to June 2024 were included in the study. Corneal sensation， Schirmer I test results， tear film break-up time （TBUT）， and corneal fluorescein staining scores were evaluated in both eyes one day before and one day after the surgery. Results The tear secretion values and TBUT in both eyes of TN patients were lower than normal. Preoperatively， there were no statistically significant differences in various ocular examinations between the two eyes （P = 0.144， P = 0.072， P = 0.069， P = 1.000）. One day postoperatively， the corneal sensitivity， tear secretion value， and TBUT of the affected eye were significantly lower compared to the contralateral eye （P < 0.01， P < 0.01， P < 0.01）， while the fluorescein staining score showed a slight increase but was not statistically significant （P = 0.157）. Compared to preoperative levels， the postoperative corneal sensitivity， tear secretion value， and TBUT of the affected side were significantly reduced （P < 0.01， P < 0.01， P < 0.01）， while the fluorescein staining score showed a slight increase but remained non?significant （P = 0.157）. Conclusions TN patients patients exhibit reduced bilateral tear secretion and compromised tear film stability. Following balloon compression surgery， the corneal sensitivity of the affected eye diminishes， leading to a further decline in tear secretion and tear film stability. Consequently， it is imperative that TN patients receive ophthalmic intervention， treatment， and regular follow?up， irrespective of whether they undergo surgery.

Key words: trigeminal neuralgia, balloon compression surgery, ocular surface changes

CLC Number:

R459.9

Rui LIU,Shijuan WANG,Tieniu ZHENG,Wensheng. CHEN. Changes in the ocular surface of patients with trigeminal neuralgia treated with percutaneous balloon compression of the trigeminal ganglion[J]. The Journal of Practical Medicine, 2025, 41(2): 215-219.

Figures/Tables 5

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

References 23

1	ARAYA E I， CLAUDINO R F， PIOVESAN E J， et al. Trigeminal Neuralgia： Basic and Clinical Aspects［J］. Curr Neuropharmacol， 2020， 18（2）： 109-119. doi:10.2174/1570159x17666191010094350 doi: 10.2174/1570159x17666191010094350
2	JAIN A. Comparative Analysis of Balloon Compression and Radiofrequency Ablation in Idiopathic Trigeminal Neuralgia： A Retrospective Study with a 24-Month Follow-up ［J］. Turk J Anaesthesiol Reanim， 2019， 47（2）： 146-150. doi:10.5152/tjar.2019.53533 doi: 10.5152/tjar.2019.53533
3	MERTSCH S， ALDER J， DUA H S， et al. ［Pathogenesis and epidemiology of neurotrophic keratopathy］［J］. Ophthalmologe， 2019， 116（2）： 109-119. doi:10.1007/s00347-018-0823-9 doi: 10.1007/s00347-018-0823-9
4	王佳娣，刘悦，宗贝婷，等. 杞菊润目颗粒联合玻璃酸钠滴眼液治疗干眼症的临床研究［J］. 现代药物与临床，2023，38（7）：1746-1751.
5	ALTAS M， OLTULU P， UCA A U， et al. Impact of unilateral trigeminal neuralgia on bilateral ocular surface alterations［J］. Headache， 2022， 62（8）： 1039-1045. doi:10.1111/head.14370 doi: 10.1111/head.14370
6	夏英华，闵飞祥，余桂，等. 球囊压迫术与微血管减压术治疗原发性三叉神经痛的对比研究［J］. 中国疼痛医学杂志，2024，30（4）：274-281.
7	何宝岩，高乃康，徐成伟. 经皮三叉神经半月节球囊压迫术治疗三叉神经痛临床分析［J］. 内蒙古医科大学学报，2023，45（3）：283-286.
8	TATLI M， SATICI O， KANTOLAP Y， et al. Various surgical modalities for trigeminal neuralgia： Literature study of respective long-term outcomes［J］. Acta Neurochir（Wien）， 2008， 150（3）： 243-255. doi:10.1007/s00701-007-1488-3 doi: 10.1007/s00701-007-1488-3
9	NI H， WANG Y， CHEN X， et al. Outcomes of Treatment for Elderly Patients With Trigeminal Neuralgia： Percutaneous Balloon Compression Versus Microvascular Decompression［J］. Craniofac Surg， 2020， 31（7）： e685-e688. doi:10.1097/scs.0000000000006544 doi: 10.1097/scs.0000000000006544
10	ZHENG S， YUAN R， NI J， et al. Long-term recurrence-free survival and complications of percutaneous balloon compression and radiofrequency thermocoagulation of Gasserian ganglion for trigeminal neuralgia： A retrospective study of 1313 cases［J］. Pain Pract， 2022， 22（5）： 532-540. doi:10.1111/papr.13114 doi: 10.1111/papr.13114
11	张媛婧，王稳，刘春华，等. 经皮微球囊压迫术和射频热凝术治疗原发性三叉神经痛的有效性和安全性研究［J］. 中国疼痛医学杂志， 2024， 30（3）：183-188.
12	YADAV S， SONONE R M， JAISWARA C， et al. Long-term Follow-up of Trigeminal Neuralgia Patients treated with Percutaneous Balloon Compression Technique： A Retrospective Analysis［J］. Contemp Dent Pract， 2016， 17（3）： 263-266. doi:10.5005/jp-journals-10024-1838 doi: 10.5005/jp-journals-10024-1838
13	TAHA J M， TEW J M Jr. Comparison of surgical treatments for trigeminal neuralgia： Reevaluation of radiofrequency rhizotomy［J］. Neurosurgery， 1996， 38（5）： 865-871. doi:10.1097/00006123-199605000-00001 doi: 10.1097/00006123-199605000-00001
14	AGAZZI S， CHANG S， DRUCKER M D， et al. Sudden blindness as a complication of percutaneous trigeminal procedures： Mechanism analysis and prevention［J］. Neurosurg， 2009， 110（4）： 638-641. doi:10.3171/2008.5.17580 doi: 10.3171/2008.5.17580
15	NOORNNI I， LODGE A， VAJRAMANI G， et al. Comparing Percutaneous Treatments of Trigeminal Neuralgia： 19 Years of Experience in a Single Centre［J］. Stereotact Funct Neurosurg， 2016， 94（2）： 75-85. doi:10.1159/000445077 doi: 10.1159/000445077
16	NOORANI I， LIDGE A， DURNFOED A， et al. Comparison of first-time microvascular decompression with percutaneous surgery for trigeminal neuralgia： Long-term outcomes and prognostic factors［J］.Acta Neurochir （Wien）， 2021， 163（6）： 1623-1634. doi:10.1007/s00701-021-04793-4 doi: 10.1007/s00701-021-04793-4
17	GUERRERO-MORENO A， BAUDOUIN C， MELIK PARSADININATZ S， et al. Morphological and Functional Changes of Corneal Nerves and Their Contribution to Peripheral and Central Sensory Abnormalities［J］. Front Cell Neurosci， 2020， 14： 610342. doi:10.3389/fncel.2020.610342 doi: 10.3389/fncel.2020.610342
18	AL-AQABA M A， DHILLION V K， MOHAMMED I， et al. Corneal nerves in health and diseases［J］.Prog Retin Eye Res， 2019， 73： 100762. doi:10.1016/j.preteyeres.2019.05.003 doi: 10.1016/j.preteyeres.2019.05.003
19	DUA H S， SAID D G， MESSMER E M， et al. Neurotrophic keratopathy ［J］. Prog Retin Eye Res， 2018， 66： 107-131. doi:10.1016/j.preteyeres.2018.04.003 doi: 10.1016/j.preteyeres.2018.04.003
20	JABBOUR S， ASHTON C， BALAL S， et al. The management of neurotrophic keratitis［J］. Curr Opin Ophthalmol， 2021， 32（4）： 362-368. doi:10.1097/icu.0000000000000766 doi: 10.1097/icu.0000000000000766
21	陈旺，李红. 人工泪液联合地夸磷索钠滴眼液治疗干眼症疗效及对炎症因子影响［J］. 贵州医药，2023，47（12）：1949-1951.
22	NAPIER E， CAMACHO M， MCDEVITT T F， et al. Neurotrophic keratopathy： Current challenges and future prospects ［J］. Ann Med， 2022， 54（1）： 666-673. doi:10.1080/07853890.2022.2045035 doi: 10.1080/07853890.2022.2045035
23	DHILLON V K， ELALFY M S， AL-AQABA M， et al. Corneal hypoesthesia with normal sub-basal nerve density following surgery for trigeminal neuralgia［J］. Acta Ophthalmol， 2016， 94（1）： e6-e10. doi:10.1111/aos.12697 doi: 10.1111/aos.12697

组别	眼数	术前1 d	术后1 d	Z值	P值
患侧眼	30	60（53.75，60）	30（30，40）	-3.857	< 0.001
对侧眼	30	60（58.75，60）	60（50，60）	-1.872	0.061
Z值		-1.462	-4.658
P值		0.144	< 0.001

组别	眼数	术前1 d	术后1 d	Z值	P值
患侧眼	30	7.50（5.75，10.00）	4.00（2.00，6.25）	3.897	< 0.001
对侧眼	30	8.00（8.00，12.00）	9.00（6.75，10.00）	1.770	0.77
Z值		-1.802	-4.251
P值		0.072	< 0.001

组别	眼数	术前1 d	术后1 d	Z	P值
患侧眼	30	7.00（5.00，9.00）	4.00（3.00，5.25）	-4.489	< 0.001
对侧眼	30	8.00（7.00， 10.00）	8.00（6.00， 10.00）	-0.718	0.473
Z值		-1.816	-4.553
P值		0.069	< 0.001

组别	眼数	术前1 d	术后1 d	Z值	P值
患侧眼	30	0（0，0）	0（0，0）	1.414	0.157
对侧眼	30	0（0，0）	0（0，0）	0.000	1.000
Z值		0.000	-1.414
P值		1.000	0.157

组别	眼数	干眼症问卷评分		Z值	P值
组别	眼数	治疗前	治疗后	Z值	P值
健康组	60	9（7,11）	-
TN组	60	9（8,12）	9（8，11）	0.690	0.490
Z值		1.509	0.915
P值		0.131	0.360

Changes in the ocular surface of patients with trigeminal neuralgia treated with percutaneous balloon compression of the trigeminal ganglion

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 5

References 23

Related Articles 3

Recommended Articles

Metrics

Comments

[1]	Shuling SUN,Yuling XING,Jiangmei GONG,Ni. ZHANG. The relationship and clinical risk assessment between trigeminal nerve atrophy and pontine angle and recurrence after percutaneous radiofrequency thermocoagulation in ITN patients [J]. The Journal of Practical Medicine, 2024, 40(15): 2133-2137.
[2]	SONG Xudong, LUO Bo, LIU Yi, CHEN Huaxuan, WANG Xiaoya.. 3D slicer combined with sina software assisted percutaneous balloon compression for trigeminal neuralgia [J]. The Journal of Practical Medicine, 2022, 38(9): 1120-1124.
[3]	JIN Donghua, LIU Zhan, NIU Guangming, TAO Shengzhong, GENG Xiaoteng, WANG Zaib⁃ in, LU Huipeng. . Value of multimodal 3D volume rendering reconstruction in preoperative evaluation of microvascular decompression [J]. The Journal of Practical Medicine, 2021, 37(9): 1193-1198.