
==== Front
Neurosurg Rev
Neurosurg Rev
Neurosurgical Review
0344-5607
1437-2320
Springer Berlin Heidelberg Berlin/Heidelberg

2896
10.1007/s10143-024-02896-x
Correspondence
Letter to the Editor: The extracapsular capsule phenomenon of percutaneous balloon compression provides adequate compression of the third branch of the trigeminal nerve: a retrospective study
Rizvi Syeda Vilay Zehra 1
Haseeb Abdul 1
Rizvi Syeda umme Abiha 1
Fatima Sabika 1
Iqbal Javed jiqbal3@hamad.qa

2
Zubair Muhammad 3
1 https://ror.org/010pmyd80 grid.415944.9 0000 0004 0606 9084 Department of Medicine, Jinnah Sindh Medical University, Rafiqui H.J Shaheed Road, Karachi, Pakistan
2 https://ror.org/02zwb6n98 grid.413548.f 0000 0004 0571 546X Department of Nursing, Hamad Medical Corporation, Doha, Qatar
3 Department of Medicine, Jinnah Post Graduate Medical Centre, Rafiqui H.J Shaheed Road, Karachi, Pakistan
21 9 2024
21 9 2024
2024
47 1 6572 9 2024
2 9 2024
15 9 2024
© The Author(s) 2024
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
http://dx.doi.org/10.13039/100019779 Qatar National Library issue-copyright-statement© Springer-Verlag GmbH Germany, part of Springer Nature 2024
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pmcDear Editor,

We recently read an article in your esteemed journal and were captivated by its content. We extend our heartfelt congratulations to the authors for their dedication and commitment to their research. We are writing to critique the recent publication titled “The extracapsular capsule phenomenon of percutaneous balloon compression provides adequate compression of the third branch of the trigeminal nerve: A Retrospective Study.” The study evaluates the efficacy of the extracapsular capsule technique in treating trigeminal neuralgia (TN) with percutaneous balloon compression (PBC), particularly focusing on the trigeminal nerve’s third branch (V3). The results suggest that the extracapsular capsule approach may be a more effective treatment for TN affecting the V3 branch, leading to better compression rates and postoperative outcomes. While the study offers valuable insights, we have identified limitations that prompted this critique, aiming to contribute to the existing knowledge and encourage further high-quality research in this area [1].

This study presents valuable clinical insights, indicating that the extracapsular balloon shape is a more effective and advanced treatment for trigeminal neuralgia, particularly in the third branch, compared to the traditional pear-shaped balloon. Additionally, the study demonstrates that the extracapsular approach provides improved compression of the V3 branch and ensures that this method does not result in serious complications, with only temporary masticatory muscle weakness [2].

The study’s retrospective design may introduce biases in data collection and medical record accuracy. With only 52 patients, the sample size is relatively small, suggesting that a larger cohort would yield more generalizable results. Conversely, Tang et al., prospective study comprising of  400 Trigeminal Neuralgia(TN) patients offers a more robust sample size [3]. The study does not consider the effects of demographic factors such as age, gender, and TN duration on PBC outcomes with different balloon shapes. In contrast, another retrospective cohort study evaluates demographic and clinical characteristics, including preoperative ECG results, smoking and alcohol history, age, gender, height, weight, BMI, TN laterality, affected territory, comorbidities (diabetes and hypertension), medication use (carbamazepine or oxcarbazepine), ASA status, and medication [4].

The study demonstrates that the extracapsular technique in percutaneous balloon compression for trigeminal neuralgia’s ,third branch offers significant advancements. Improvements in compression effectiveness and reduced complication rates are promising. However, addressing limitations in study design, sample size, and demographic factors could enhance the findings validity and applicability. Future research, especially prospective studies with larger samples and a thorough examination of various influencing factors, is necessary to validate and expand these results. This will contribute to a deeper understanding of the extracapsular technique’s efficacy and help refine treatment strategies for trigeminal neuralgia.

Author contributions

SVZR and AH did conceptualizationSUAR, SF and JI performed writingMZ and AH did final editing.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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References

1. Fu L, Liu Z, Bu H, Lu Z, Kong C, Wang T, et al. The extracapsular capsule phenomenon of percutaneous balloon compression provides adequate compression of the third branch of the trigeminal nerve: a retrospective study. Neurosurg Rev. 2024 Aug 28;47(1):499.
2. Du Y, Yang D, Dong X, Du Q, Wang H, Yu W. Percutaneous balloon compression (PBC) of trigeminal ganglion for recurrent trigeminal neuralgia after microvascular decompression (MVD). Ir J Med Sci. 2015 Dec;184(4):745–51.
3. Tang Q, Gao S, Wang C, Zheng K, Zhang J, Huang H, et al. A prospective cohort study on perioperative percutaneous balloon compression for trigeminal neuralgia: safety and efficacy analysis. Neurosurg Rev. 2024 Feb 17;47(1):86.
4. Zhang H, Zhang M, Guo H, Liu M, He J, Li J. Risk factors associated with trigeminocardiac reflex in patients with trigeminal neuralgia during percutaneous balloon compression: A retrospective cohort study. Clin Neurol Neurosurg. 2023 Aug;231:107834.
