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Clinical Research
Available online 9 May 2024
Gamma Knife radiosurgery for the treatment of trigeminal neuralgia: A single center-experience
Radiocirugía Gamma-Knife para el tratamiento de la neuralgia del trigémino: una experiencia en un solo centro
Mehmet Osman Akcakayaa, Muyassar Mirkhasilovab, Onur Ozturkc,
Corresponding author
onurozturk.ial@gmail.com

Corresponding author.
, Doga Ugurlard, Mehmet Tongee, Gul Alcof, Tulay Ercanf, Sefik Igdemf, Selhan Karaderelera
a Department of Neurosurgery, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
b Department of Neurosurgery, Rami Hospital, Istanbul, Turkey
c Department of Neurosurgery, Acibadem Taksim Hospital, Istanbul, Turkey
d Department of Neurosurgery, Samatya Training and Research Hospital, Istanbul, Turkey
e Department of Neurosurgery, Medipol Mega Hospital, Istanbul, Turkey
f Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
Received 16 November 2023. Accepted 20 March 2024
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Table 1. Demographics.
Table 2. Previous surgery.
Table 3. Early and final BNI scale.
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Abstract
Introduction and objectives

We aimed to assess the outcomes of patients with trigeminal neuralgia (TGN) who underwent Gamma Knife radiosurgery (GKRS).

Materials and methods

Fifty-three patients with typical TGN underwent GKRS from May 2012 until December 2022. Among these patients, 45 patients who were follow-up for at least 12 months were included in the study. A mean dose of 87.5 Gy (range, 80–90) was administered to the trigeminal nerve. Postoperatively, outcome was considered excellent if the patient was pain- and medication-free.

Results

The mean symtpom duration was 9.53 years, and the mean patient age was 59.8 years (range, 34–85). The mean follow-up period was 46.8 months (range, 12–127 months). 46.7% of patients had a history of previous surgical interventions. A single nerve division was affected in 14 patients (31.1%), and multiple divisions were affected in 31 patients (68.9%). The rate of initial pain relief was 80%. Hypoesthesia in the area of trigeminal nerve developed in 30 (66.7%). Twenty patients (44.4%) exhibited excellent results within 72.4 months. Recurrence occurred in 11 patients (24.4%) with 27.6 months.

Conclusions

Our results suggest that GKRS is a safe and effective procedure. Thus, it is an attractive first- and second-line treatment choice for TGN.

Keywords:
Trigeminal neuralgia
Gamma Knife
Radiosurgery
Outcome
Abbreviations:
BNI Scale
CISS
GKRS
MRI
MS
MVD
PBC
PGR
RF
TGN
Resumen
Introducción y objetivos

Nuestro objetivo fue evaluar los resultados de los pacientes con neuralgia del trigémino (TGN) que se sometieron a radiocirugía con Gamma Knife (GKRS)

Materiales y Métodos

Cincuenta y tres pacientes con TGN tipica se sometieron a GKRS entre mayo de 2012 y diciembre de 2022. Entre estos pacientes, se incluyeron al estudio 45 pacientes que fueron seguidos durante al menos 12 meses. Se administró una dosis media de 87,5 Gy (rango, 80-90) al nervio trigémino. El resultado postoperatorio se consideró excelente si el paciente no padecía dolor ni medicación.

Resultados

La duración media de los síntomas fue de 9,53 años y la edad media de los pacientes fue de 59,8 (rango, 34 a 85). El período medio de seguimiento fue de 46,8 meses (rango, 12-127 meses). El 46,7% de los pacientes tenía antecedentes de intervenciones quirúrgicas previas. Una sola división nerviosa se vio afectada en 14 pacientes (31,1%) y multiples divisiones en 31 pacientes (68,9%). La tasa de alivio del dolor inicial fue del 80%. La hipoestesia en el área de distribución del nervio trigémino se desarolló en 30 pacientes (66,7%).Viente pacientes (44,4%) mostraron excelentes resultados en 72,4 meses. La recurrencia se desarolló en 11 pacientes (24,4%) con 27,6 meses.

Conclusiones

Nuestros resultados sugieren que GKRS es un procedimiento seguro y eficaz. Por tantı, es una opción atractiva de primera y segunda línea para la TGN.

Palabras clave:
Neuralgia del trigémino
Gamma-Knife
Radiocirugía
Resultado

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