Background: Percutaneous balloon compression of the gasserian ganglion is an effective management of trigeminal neuralgia and is the only percutaneous procedure that preferentially may be performed under general anesthesia. However, the anatomy of Meckle's cave dictates the degree of compression, and if capacious, the usual smaller balloons may fail to adequately compress the ganglion.
Methods: We designed a series of larger cannulas, placed over a guidewire technique for using larger balloons, or even multiple balloons, to increase the applicability of this technique in these patients.
Results: In select cases, where smaller balloons fail to distort and deform the ganglion, with resultant poor clinical results, larger or multiple balloons may produce the desired response of pain relief.
Conclusion: This technique is an added resource in managing this condition.