Typical case: Ms. Shi, 67 years old, from Shuozhou City, Shanxi Province, underwent microballoon compression surgery in Shenyang 15 years ago for left-sided trigeminal neuralgia. Unexpectedly, in August of this year, her right trigeminal nerve also suddenly became painful. After 20 days, Ms. Shi found Director Ma Jihong and his team, and after examination, she was treated with balloon compression (“Little Pear”) for her right trigeminal neuralgia. The day after the surgery, Ms. Shi smiled and said, “Now I can eat, talk and drink without pain.” Ms. Shi complained that the reason she was so eager to treat her trigeminal neuralgia was because she was too hungry, and her trigger point of trigeminal neuralgia was in the area of her teeth and mouth, where the slightest movement of opening her mouth and brushing her teeth could trigger severe pain. ”The micro-balloon compression surgery is performed by puncturing the affected corner of the mouth, placing a micro-balloon catheter precisely in the vicinity of the trigeminal ganglion through the foramen ovale under X-ray guidance, then filling the micro-balloon and compressing the trigeminal ganglion for 1.5-3 minutes to block the pain. -3 minutes to achieve pain blockage. The shape of the balloon determines the efficacy of the surgery, and the pear shape (also can be bowling ball shape, ping pong beat shape, etc.) is an important sign of good surgical results, which is what we call a “small pear” to solve the world’s first pain. How to treat bilateral trigeminal neuralgia Bilateral trigeminal neuralgia like Ms. Shi is relatively rare in patients with primary trigeminal neuralgia, accounting for about 5% of the patients. At present, the clinical treatment of unilateral trigeminal neuralgia is mostly performed by microvascular decompression surgery or balloon compression, and the same method can be used for the treatment of primary bilateral trigeminal neuralgia. Whether microvascular decompression or balloon compression is used, it cannot be applied bilaterally at the same time, and treatment needs to be spaced out according to the patient’s specific condition. Bilateral trigeminal neuralgia rarely occurs on both sides at the same time, usually occurring first on one side, or heavier on one side and lighter on the other. Most of the pain starts on the maxillary or mandibular branch side, and the pain can gradually spread from one branch to the other, or even all three branches are involved. Can trigeminal neuralgia be operated on for 20 days Trigeminal neuralgia is a developmental disease that does not usually heal on its own. Many patients have been enduring the pain or have done a lot of pain-relieving treatment because they are apprehensive about surgery, but the pain still exists. The director of neurosurgery department of Shanxi Provincial People’s Hospital, Ma Jiuhong, introduced that trigeminal neuralgia can be relieved by taking some anti-epileptic drugs such as carbamazepine to relieve the pain at the early stage of its onset, and due to the side effects of the drugs, the patient’s liver and kidney function should be checked regularly while taking the drugs. Once the diagnosis of primary trigeminal neuralgia is confirmed, all can be treated by minimally invasive surgery. The only radical treatment method: microvascular decompression surgery Microvascular decompression surgery is a minimally invasive surgery in which a 3-4 cm incision is made in the skin behind the ear to expose the skull, and then a small hole of about 2 mm in diameter is drilled in the bone. A special spacer is then used to separate the vessel from the nerve so that the vessel cannot touch the trigeminal nerve when it is pulsating. At present, microvascular decompression surgery is the only way to cure trigeminal neuralgia, with a cure rate of over 92%. Rapid pain relief: microballoon compression surgery Microballoon compression surgery for trigeminal neuralgia is also called “surgery within the tip of a needle”, and the entire incision is only the size of a needle eye. The operation time is short and the patient is pain-free under general anesthesia. After confirming the correct direction and position of the puncture under fluoroscopy, a balloon catheter is introduced into the trigeminal nerve at the location of the meniscus to compress the trigeminal nerve at a specific location, thereby inactivating the nociceptive fibers of the trigeminal nerve and achieving the goal of treating trigeminal neuralgia.