• Jianwei Shi, Fuduo Bo, Ruihan Pan, Yansong Zhang, Yang Xu, Hairong Chen, Honglin Ge, Xianwen Cao, Yan Xia, and Zhengxiang Luo.
• Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
• World Neurosurg. 2022 Dec 1; 168: e369e375e369-e375.

ObjectivePercutaneous balloon compression is a safe, effective, and minimally invasive therapeutic method for trigeminal neuralgia. Intraoperatively precise compression after the formation of the pear-shaped balloon is the key to the expected effect. In this study, we assessed the relationship between the structure of Meckel's cavity and the shape and intracapsular pressure of the balloon by preoperative magnetic resonance.MethodsWe respectively analyzed 58 patients with typical trigeminal neuralgia who underwent percutaneous balloon compression surgery in our department. Reconstruction of magnetic resonance imaging 3-dimensional fast imaging employing steady-state acquisition thin-layer scanning sequence was also performed before the operation to analyze the sagittal features of Meckel's cavity. The pressure was recorded continuously when a pear-shaped balloon was forming during the operation. Meanwhile, the balloon height/length (h/l) ratio was measured. The relationship between Meckel's cavity shape, balloon shape, and pressure was analyzed by mentioned parameters.ResultsThe pain of 57 patients was relieved immediately after the operation, and the effective rate was 98.27% (57 of 58); Recurrence in 2 cases within the median follow-up time (7.5 months). Meckel's cavity classification on magnetic resonance showed that the clubbing type, oval type, and flat type accounted for 31.1% (18 of 58), 58.6% (34 of 58), and 10.3% (6 of 58), respectively. The results demonstrated that the intracapsular pressure was low, while the h/l ratio of Meckel's cavity was relatively high. We also found the corresponding pressure results when the ratio was low. However, no significant difference was found between the balloon h/l ratio and Meckel's cavity h/l ratio.ConclusionsIntracapsular pressure of balloon is negatively correlated with the h/l ratio of Meckel's cavity. The individually differentiated formation of the pear-shaped balloon has little correlation with the sagittal shape of Meckel's cavity.Copyright © 2022 Elsevier Inc. All rights reserved.

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