| Gamma Knife surgery used as primary and repeated treatment for idiopathic trigeminal neuralgia. | |
MedLine Citation:
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PMID: 19123906 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECT: The purpose of this study was to assess the outcome of idiopathic trigeminal neuralgia (TN) treated with Gamma Knife surgery (GKS) as a primary and repeated treatment modality with a mean follow-up of 5.7 years. METHODS: Between July 1999 and September 2005, a total of 89 patients with idiopathic TN underwent GKS as a primary treatment. The entry zone of the TN was targeted with a 4-mm collimator and treated with a maximal dose of 60-90 Gy (mean 79 Gy). The dose to the pontine margin was always kept < 15 Gy. Twenty patients received repeated GKS for recurrent or residual pain with a maximal dose of 40-76 Gy (mean 52 Gy). For the second procedure, the target was positioned at the same location as the first treatment. RESULTS: The mean follow-up period was 68 months (range 32-104 months). Sixty-nine (77.5%) of the 89 patients experienced a favorable response, as follows: 50 (56%) had excellent, 12 (13.5%) had good, and 7 (7.8%) had fair outcomes. The mean time to pain relief was 1.1 months (range 2 days-6 months). No significant correlation, but more likely a tendency, was found between the dose and pain relief (p = 0.08). Also, no correlation was noted for facial numbness (p = 0.77). The mean follow-up period after repeated GKS was 60 months (range 32-87 months). Outcomes after repeated GKS were excellent in 11 patients (55%) and good in 1 (5%). Seven patients experienced facial numbness. No correlation was found between the additive dose and pain relief (p = 0.24) or facial numbness (p = 0.15). Final outcomes of primary and repeated GKS were excellent in 61 (68.5%), good in 13 (14.6%), and fair in 7 (7.9%). In total, 91% of the patients were successfully treated with this method. There was no statistical significance for efficacy between primary and repeated GKS (p = 0.65), but there was a significant difference for facial numbness (p = 0.007). CONCLUSIONS: Gamma Knife surgery established durable pain relief when used as a primary and repeated surgery. Treatment was successful for a total of 91% of patients at a mean follow-up of 5.7 years, but facial numbness was also relatively higher. |
Authors:
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Chuan-Fu Huang; Hsien-Tang Tu; Wen-Shan Liu; Shyh-Ying Chiou; Long-Yau Lin |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neurosurgery Volume: 109 Suppl ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2009-01-06 Completed Date: 2009-01-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 179-84 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurosurgery, Chung-Shan Medical University, Taichung, Taiwan. gk@csh.org.tw |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Female Follow-Up Studies Humans Male Middle Aged Radiosurgery* Recurrence Retreatment Retrospective Studies Rhizotomy Survival Analysis Time Factors Treatment Outcome Trigeminal Neuralgia / etiology, surgery* |
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