J Korean Neurosurg Soc.  2012 May;51(5):276-280. 10.3340/jkns.2012.51.5.276.

Long Term Outcomes of Gamma Knife Radiosurgery for Typical Trigeminal Neuralgia-Minimum 5-Year Follow-Up

• Lee JK
• Choi HJ
• Ko HC
• Choi SK
• Lim YJ

• KMID: 2066926
• DOI: http://doi.org/10.3340/jkns.2012.51.5.276

Abstract

OBJECTIVE
Gamma knife radiosurgery (GKRS) is the least invasive surgical option for patients with trigeminal neuralgia (TN). However, the indications and long term outcomes of GKRS are still controversial. Additionally, a series with uniform long-term follow-up data for all patients has been lacking. In the present study, the authors analyzed long-term outcomes in a series of patients with TN who underwent a single GKRS treatment followed by a minimum follow-up of 60 months.
METHODS
From 1994 to 2009, 40 consecutive patients with typical, intractable TN received GKRS. Among these, 22 patients were followed for >60 months. The mean maximum radiation dose was 77.1 Gy (65.2-83.6 Gy), and the 4 mm collimator was used to target the radiation to the root entry zone.
RESULTS
The mean age was 61.5 years (25-84 years). The mean follow-up period was 92.2 months (60-144 months). According to the pain intensity scale in the last follow-up, 6 cases were grades I-II (pain-free with or without medication; 27.3%) and 7 cases were grade IV-V (<50% pain relief with medication or no pain relief; 31.8%). There was 1 case (facial dysesthesia) with post-operative complications (4.54%).
CONCLUSION
The long-term results of GKRS for TN are not as satisfactory as those of microvascular decompression and other conventional modalities, but GKRS is a safe, effective and minimally invasive technique which might be considered a first-line therapy for a limited group of patients for whom a more invasive kind of treatment is unsuitable.

Keyword

Trigeminal neuralgia; Gamma knife radiosurgery; Long-term follow-up

MeSH Terms

Follow-Up Studies
Humans
Microvascular Decompression Surgery
Radiosurgery
Trigeminal Neuralgia

Figure

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  Fig. 1 A single 4-mm isocenter was used to irradiate the root entry zone of the trigeminal nerve.

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