Gasserian Gang. Balloon Compression

[lovebailey2001]

I am doing Percutaneous Ballon compression for Trigeminal Neuralgia since last one year, especially for V1 and V2 divisions. Apart from mild to mod. masseter weakness and mild hypesthesia no other significant side effect. Effect is immidiate and wonderful, longest followup is of 10 mths. Yet my concern is- that I am not getting the ideal 'Pear Shape' during balloon inflation, most of the time it is either a 'Bullet Shape' or 'Army Helmet' shape.
Does any body on thsi forum is doing PBC for TGN! Any tip to get ideal pear shape wud be appreciated.

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[lobelsteve]

I only do local + dex or local and pulsed to the ganglion. 6-12 months of 50+% pain relief. n =15 per year. No paresthesia, weakness, corneal denervation.

 

[Pacman27]

Dr Lobel,

What is the approach to pulsing you utilize. Is is 42 degrees for 120 seconds and how many rounds with what gauge needle. I can not say I get great results with the pulsing. We usually do 60 degrees for 75 seconds, with 2 to 3 lesions. Decent results.

Also, how do you bill for the Pulse?

Thanks

 

[lobelsteve]

Dr Lobel,

What is the approach to pulsing you utilize. Is is 42 degrees for 120 seconds and how many rounds with what gauge needle. I can not say I get great results with the pulsing. We usually do 60 degrees for 75 seconds, with 2 to 3 lesions. Decent results.

Also, how do you bill for the Pulse?

Thanks

240 seconds x2 with 22G 5mm tip. Use Way Yin technique.

I don't bill for it. I just do it.

 

[Louisville04]

240 seconds x2 with 22G 5mm tip. Use Way Yin technique.

I don't bill for it. I just do it.

Your check from Nike is in the mail.

 

[nvrsumr]

Lovebailey-Its cool youre doing those. Havent done a gasserian since fellowship.

 

[lovebailey2001]

Lovebailey-Its cool youre doing those. Havent done a gasserian since fellowship.

Thanx! It is really a humbling experience to treat TGN, I understand why Dr Lobel doesn't bill it! I used to do RF earlier, but it was really difficult to find II and Ist division and dysesthesias and corneal blunting were really bothersome, so I swiched to balloon.

 

[Pacman27]

Haven't ever done the balloon Do you mind sharing where you get the balloon from

One of my favorite procedures to do, especially if it is truely a case of TGN.

 

[lovebailey2001]

Sure thing! This is simple Fogarty Embolectomy catheter with size 4 Fr used by interventional cardiologists primarily. You can use it 14 G cannula to enter the meckel's cave. Good luck..