COVID-19 restrictions to remain in place at The Walton Centre

Restrictions remain in place across the NHS in relation to the COVID-19 pandemic. The safety measures in place over the 18 months therefore remain in place at The Walton Centre - and in our other clinic settings within the community – until further notice.

Due to the increased transmission risk posed by the Omicron variant, visiting has been suspended within The Walton Centre except for exceptional circumstances.

Balloon Compression of Trigeminal Ganglion

What is Balloon Compression?

It is a procedure to selectively affect the trigeminal ganglion (part of the nerve conveying pain signals to the brain) in such a way as to disrupt pain signals from getting through to the brain. A balloon is inflated inside the skull to compress the ganglion and help with pain relief.

Where is it done?

The procedure is carried out in the Radiology theatre/operating theatre at The Walton Centre.

How is it done?

The procedure is performed under general anesthesia in a short period of time. X-ray pictures are taken throughout the procedure to help direct the needle to the correct place.

A needle is inserted through the cheek under x ray until it just passes through the foramen ovale (a hole in the base of skull, through which the nerve comes out of skull).

A catheter (with small balloon at the tip) is then advanced through the needle and the balloon is slowly inflated. The entire procedure takes only 30 minutes. The balloon is deflated and then withdrawn along with the needle. Dressing is then applied to the cheek.

How long will I be in hospital?

Although the procedure itself only takes 30 minutes you may be admitted for an overnight stay to make sure there are no problems.

Can I eat and drink?

Minimum of six hours of fasting is required before the procedure but clear instructions will be given to you with regards to this before your admission.
You will be offered a drink after the procedure when you have come back to the ward from recovery.

Can I take my usual tablets?

Yes. Take your usual medication and bring your medications with you.
(Patients taking warfarin/ Clopidogrel/ Aspirin will be given individual information).

What can go wrong?

It is usually a very safe procedure but is associated with very rare risks as any other invasive procedure.

The side effects which are common but not serious are:

  • Mild discomfort at the site of the injection; this should last
    no longer than 48 hours However if the pain is severe or you feel unwell you should consult your own Doctor (GP) or us.
  • You will experience numbness of the face, tongue or throat which gradually diminishes. Your face may feel swollen to you but it will look normal in the mirror. Some patients do not like this numbness.
  • Jaw weakness is very common but rarely troublesome and usually settles in a couple of months.

 

The side effects which are serious but not common are:

  • Three out of one hundred patients who have this procedure stand a chance of having infection of the brain (Meningitis)
  • One out of fifty patients who have this procedure stands a chance of having bleeding in the brain.
  • One out of one hundred patients who have this procedure can have visual disturbance or dryness of the eye on same side.
  • Anesthesia dolorosa where you may be left with troublesome numbness of the face and continuous pain. It is a rare but reported complication.
  • Death & serious catastrophe has also been reported but are extremely rare.

Will it work?

The balloon compression is very effective but does not work for everyone. It works in 9 out of 10 patients.

What happens next?

We will ask you to reduce your pain medication gradually. You will be reviewed in the outpatients department in 4-6 weeks following your procedure.

Will my Pain Return?

It has been observed that in one out of five patients, the pain returns in two years time. When it happens it is more manageable with medications. The procedure can be easily repeated, if needed.

What are the other options?

One option is do nothing & get the best pain relief possible from your medication. You may have already tried this or may not be able to tolerate the side effects.
Other options are techniques such as Radiofrequency ablation or Gamma knife surgery. You can discuss these options with your consultant. Gamma knife surgery is available in the Walton Centre.

Contact details

Dr M L Sharma
Consultant in Pain Medicine Walton Centre
0151 525 3611

  • Last Updated:
    01 April 2018
  • Review Date:
    01 April 2022
  • Author:
    Dr Sharma
  • Summary:

    A procedure to selectively affect the trigeminal ganglion

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