| Summary: | Objective：To explore the clinical application effect of percutaneous balloon compression (PBC) under neuronavigation guidance for the precise treatment of trigeminal neuralgia in elderly patients. Methods：A retrospective analysis was conducted on 93 elderly patients with primary trigeminal neuralgia admitted to the First Affiliated Hospital with Nanjing Medical University from May 2021 to September 2022. Forty-five patients treated with microvascular decompression surgery (MVD) were selected as the MVD group, with minimally invasive craniectomy performed with MVD by the posterior approach of the sigmoid sinus on the affected side. Forty-eight patients treated with PBC were selected as the PBC group. The patients underwent preoperative cranial MRI and cranial CT scanning to reconstruct the foramen ovale and Meckel's capsule cavity and underwent PBC under neuronavigation guidance for precise treatment of trigeminal neuralgia. The patients in the two groups were followed up for 12 months to compare the length of surgery, length of hospitalization, clinical efficacy, recurrence rate, and complication rate. Results： The surgical duration and hospitalization duration in the PBC group were significantly lower than those in the MVD group ［(21.21±5.09)min vs (118.40±15.79)min, (3.67±0.80)d vs (12.42±2.29)d, P＜0.01］. There was no statistically significant difference in the overall effective rate (97.7% vs 93.3%, P＞0.05) and recurrence rate (20.8% vs 13.3%, P＞0.05) between the PBC group and MVD group. For recurrent patients, PBC treatment was performed again, and the effect was satisfactory. The incidence of facial numbness and lip herpes were higher in the PBC group than in the MVD group (85.4% vs 8.9%, 31.2% vs 11.1%, P＜0.05), and all complications in both groups were recovered within one year. Conclusion： PBC and MVD surgeries have no difference in effectiveness and recurrence rates, both of which can effectively relieve pain. PBC significantly shortens the duration of surgery and hospitalization with its minimally invasive nature. For elderly patients who are not suitable for craniotomy surgery, PBC under neuronavigation guidance provides a safe and effective treatment for trigeminal neuralgia.
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