Percutaneous Balloon Compression for Orofacial Pain Management
- The pain management teams at the LKS Faculty of Medicine of the University of Hong Kong (HKUMed) and Queen Mary Hospital (QMH) have introduced percutaneous balloon compression (PBC)...
- Chronic orofacial pain, including conditions such as trigeminal neuralgia-characterized by sudden, severe, electric shock-like facial pain-and pain from herpes zoster, imposes a significant burden on patients.
- Dr.Stanley Wong Sau-ching, Clinical Associate Professor in the Department of Anesthesiology, School of Clinical Medicine, HKUMed, said, "Conventional pain management methods for orofacial pain frequently enough involve neuropathic...
PBC is an interventional technique that alleviates pain by inserting a small balloon into the trigeminal ganglion near the base of the skull and inflating it to compress the nerve’s pain fibers. Credit: The University of Hong Kong
The pain management teams at the LKS Faculty of Medicine of the University of Hong Kong (HKUMed) and Queen Mary Hospital (QMH) have introduced percutaneous balloon compression (PBC) as a novel treatment option for patients suffering from debilitating chronic facial pain. The teams began performing this complex neuroablative procedure in 2024,and so far,40 patients have benefited from this powerful and durable treatment.
Chronic orofacial pain, including conditions such as trigeminal neuralgia-characterized by sudden, severe, electric shock-like facial pain-and pain from herpes zoster, imposes a significant burden on patients. It often causes psychological distress and functional impairment, severely impacting their quality of life.
Dr.Stanley Wong Sau-ching, Clinical Associate Professor in the Department of Anesthesiology, School of Clinical Medicine, HKUMed, said, “Conventional pain management methods for orofacial pain frequently enough involve neuropathic pain medications, but some patients experience inadequate relief and intolerable side effects with varied success rates. Thanks to the introduction of PBC, patients who are unable or unwilling to undergo more invasive surgeries now have a promising alternative for pain management.”
Emerging as an effective alternative for pain relief
PBC is an interventional technique designed to alleviate pain associated with the trigeminal nerve, which is responsible for facial sensation.The procedure involves inserting a tiny balloon through the cheek into the trigeminal ganglion near the base of the skull and inflating it with contrast medium to gently compress the nerve’s pain fibers. Proper placement is confirmed by fluoroscopic imaging, which
Hong Kong’s pain treatment landscape has expanded with the introduction of Pulsed Radiofrequency Cryoablation (PBC), a minimally invasive technique offering relief for chronic facial pain. This new option complements existing treatments like Radiofrequency Ablation (RFA), providing clinicians with a broader range of tools to address complex cases.
PBC utilizes a combination of pulsed radiofrequency energy and cooling to selectively target and modulate pain signals. it’s particularly beneficial for patients with trigeminal neuralgia, neuropathic pain, and other chronic facial pain syndromes. PBC can be considered when multiple branches of the trigeminal nerve are involved, or for patients who prefer to avoid awake sensory testing. RFA remains an excellent treatment option for orofacial pain, especially for isolated lower-facial pain where selective lesioning is desirable.
“The addition of PBC to Hong Kong’s pain treatment options offers new hope for patients with challenging facial pain conditions,” concluded Dr. Stanley Wong Sau-ching. “We can now tailor treatment to the individual. PBC offers durable relief with a strong safety profile, particularly for complex cases. Optimal management is about having the right tool for the right patient.”