Journal of Korean Neurosurgical Society

  • 제51권5호
  • /
  • Pages.276-280
  • /
  • 2012
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지
DOI QR코드

DOI QR Code

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

  • Lee, Jong-Kwon (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
  • Choi, Hyuk-Jai (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
  • Ko, Hak-Cheol (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
  • Choi, Seok-Keun (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
  • Lim, Young-Jin (Department of Neurosurgery, School of Medicine, Kyung Hee University)
  • 투고 : 2011.12.31
  • 심사 : 2012.05.18
  • 발행 : 2012.05.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

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.

키워드

참고문헌

  1. Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD : The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334 : 1077-1083, 1996 https://doi.org/10.1056/NEJM199604253341701
  2. Brisman R : Gamma knife radiosurgery for primary management for trigeminal neuralgia. Neurosurg 93 Suppl 3 : 159-161, 2000
  3. Brisman R : Gamma knife surgery with a dose of 75 to 76.8 Gray for trigeminal neuralgia. J Neurosurg 100 : 848-854, 2004 https://doi.org/10.3171/jns.2004.100.5.0848
  4. Broggi G, Ferroli P, Franzini A, Servello D, Dones I : Microvascular decompression for trigeminal neuralgia : comments on a series of 250 cases, including 10 patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 68 : 59-64, 2000 https://doi.org/10.1136/jnnp.68.1.59
  5. Broggi G, Franzini A, Lasio G, Giorgi C, Servello D : Long-term results of percutaneous retrogasserian thermorhizotomy for "essential" trigeminal neuralgia : considerations in 1000 consecutive patients. Neurosurgery 26 : 783-786; discussion 786-787, 1990 https://doi.org/10.1227/00006123-199005000-00008
  6. Guo S, Chao ST, Reuther AM, Barnett GH, Suh JH : Review of the treatment of trigeminal neuralgia with gamma knife radiosurgery. Stereotact Funct Neurosurg 86 : 135-146, 2008 https://doi.org/10.1159/000120425
  7. Kondziolka D, Lunsford LD, Flickinger JC, Young RF, Vermeulen S, Duma CM, et al. : Stereotactic radiosurgery for trigeminal neuralgia : a multiinstitutional study using the gamma unit. J Neurosurg 84 : 940-945, 1996 https://doi.org/10.3171/jns.1996.84.6.0940
  8. Kondziolka D, Perez B, Flickinger JC, Habeck M, Lunsford LD : Gamma knife radiosurgery for trigeminal neuralgia : results and expectations. Arch Neurol 55 : 1524-1529, 1998 https://doi.org/10.1001/archneur.55.12.1524
  9. Kubicek GJ, Hall WA, Orner JB, Gerbi BJ, Dusenbery KE : Long-term follow-up of trigeminal neuralgia treatment using a linear accelerator. Stereotact Funct Neurosurg 82 : 244-249, 2004 https://doi.org/10.1159/000083176
  10. Lee KH, Chang JW, Park YG, Chung SS : Microvascular decompression and percutaneous rhizotomy in trigeminal neuralgia. Stereotact Funct Neurosurg 68(1-4 Pt 1) : 196-199, 1997 https://doi.org/10.1159/000099923
  11. Lim M, Villavicencio AT, Burneikiene S, Chang SD, Romanelli P, McNeely L, et al. : CyberKnife radiosurgery for idiopathic trigeminal neuralgia. Neurosurg Focus 18 : E9, 2005
  12. Little AS, Shetter AG, Shetter ME, Bay C, Rogers CL : Long-term pain response and quality of life in patients with typical trigeminal neuralgia treated with gamma knife stereotactic radiosurgery. Neurosurgery 63 : 915-923; discussion 923-924, 2008 https://doi.org/10.1227/01.NEU.0000327689.05823.28
  13. Longhi M, Rizzo P, Nicolato A, Foroni R, Reggio M, Gerosa M : Gamma knife radiosurgery for trigeminal neuralgia : results and potentially predictive parameters--part I : idiopathic trigeminal neuralgia. Neurosurgery 61 : 1254-1260; discussion 1260-1261, 2007 https://doi.org/10.1227/01.neu.0000306104.68635.d4
  14. Lopez BC, Hamlyn PJ, Zakrzewska JM : Stereotactic radiosurgery for primary trigeminal neuralgia : state of the evidence and recommendations for future reports. J Neurol Neurosurg Psychiatry 75 : 1019-1024, 2004 https://doi.org/10.1136/jnnp.2003.018564
  15. Lunsford LD, Young RF : Radiosurgery for trigeminal neuralgia. Surg Neurol 54 : 285-287, 2000
  16. Maesawa S, Salame C, Flickinger JC, Pirris S, Kondziolka D, Lunsford LD : Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg 94 : 14-20, 2001 https://doi.org/10.3171/jns.2001.94.1.0014
  17. McNatt SA, Yu C, Giannotta SL, Zee CS, Apuzzo ML, Petrovich Z : Gamma knife radiosurgery for trigeminal neuralgia. Neurosurgery 56 : 1295-1301; discussion 1301-1303, 2005 https://doi.org/10.1227/01.NEU.0000160073.02800.C7
  18. Petit JH, Herman JM, Nagda S, DiBiase SJ, Chin LS : Radiosurgical treatment of trigeminal neuralgia : evaluating quality of life and treatment outcomes. Int J Radiat Oncol Biol Phys 56 : 1147-1153, 2003 https://doi.org/10.1016/S0360-3016(03)00264-5
  19. Pollock BE, Phuong LK, Foote RL, Stafford SL, Gorman DA : High-dose trigeminal neuralgia radiosurgery associated with increased risk of trigeminal nerve dysfunction. Neurosurgery 49 : 58-62; discussion 62-64, 2001
  20. Pollock BE, Phuong LK, Gorman DA, Foote RL, Stafford SL : Stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg 97 : 347-353, 2002 https://doi.org/10.3171/jns.2002.97.2.0347
  21. Régis J, Métellus P, Lazorthes Y, Porcheron D, Peragut JC : Effect of gamma knife on secondary trigeminal neuralgia. Stereotact Funct Neurosurg 70 Suppl 1 : 210-217, 1998 https://doi.org/10.1159/000056424
  22. Riesenburger RI, Hwang SW, Schirmer CM, Zerris V, Wu JK, Mahn K, et al. : Outcomes following single-treatment Gamma Knife surgery for trigeminal neuralgia with a minimum 3-year follow-up. J Neurosurg 112 : 766-771, 2010 https://doi.org/10.3171/2009.8.JNS081706
  23. Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL : Gamma knife radiosurgery for trigeminal neuralgia : the initial experience of The Barrow Neurological Institute. Int J Radiat Oncol Biol Phys 47 : 1013-1019, 2000 https://doi.org/10.1016/S0360-3016(00)00513-7
  24. Rogers CL, Shetter AG, Ponce FA, Fiedler JA, Smith KA, Speiser BL : Gamma knife radiosurgery for trigeminal neuralgia associated with multiple sclerosis. J Neurosurg 97(5 Suppl) : 529-532, 2002
  25. Sindou M, Leston J, Howeidy T, Decullier E, Chapuis F : Micro-vascular decompression for primary Trigeminal Neuralgia (typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients. Acta Neurochir (Wien) 148 : 1235-1245; discussion 1245, 2006 https://doi.org/10.1007/s00701-006-0809-2
  26. Taha JM, Tew JM Jr, Buncher CR : A prospective 15-year follow up of 154 consecutive patients with trigeminal neuralgia treated by percutaneous stereotactic radiofrequency thermal rhizotomy. J Neurosurg 83 : 989-993, 1995 https://doi.org/10.3171/jns.1995.83.6.0989
  27. Tronnier VM, Rasche D, Hamer J, Kienle AL, Kunze S : Treatment of idiopathic trigeminal neuralgia : comparison of long-term outcome after radiofrequency rhizotomy and microvascular decompression. Neurosurgery 48 : 1261-1267; discussion 1267-1268, 2001
  28. Tyler-Kabara EC, Kassam AB, Horowitz MH, Urgo L, Hadjipanayis C, Levy EI, et al. : Predictors of outcome in surgically managed patients with typical and atypical trigeminal neuralgia : comparison of results following microvascular decompression. J Neurosurg 96 : 527-531, 2002 https://doi.org/10.3171/jns.2002.96.3.0527
  29. Urgosik D, Liscak R, Novotny J Jr, Vymazal J, Vladyka V : Treatment of essential trigeminal neuralgia with gamma knife surgery. J Neurosurg 102 Suppl : 29-33, 2005
  30. Urgosik D, Vymazal J, Vladyka V, Liscák R : Gamma knife treatment of trigeminal neuralgia : clinical and electrophysiological study. Stereotact Funct Neurosurg 70 Suppl 1 : 200-209, 1998 https://doi.org/10.1159/000056423
  31. Young RF, Vermulen S, Posewitz A : Gamma knife radiosurgery for the treatment of trigeminal neuralgia. Stereotact Funct Neurosurg 70 Suppl 1 : 192-199, 1998 https://doi.org/10.1159/000056422
  32. Zakrzewska JM, Thomas DG : Patient's assessment of outcome after three surgical procedures for the management of trigeminal neuralgia. Acta Neurochir (Wien) 122 : 225-230, 1993 https://doi.org/10.1007/BF01405533

피인용 문헌

  1. Trigeminal neuralgia treatment outcomes following Gamma Knife radiosurgery with a minimum 3-year follow-up vol.3, pp.None, 2012, https://doi.org/10.1007/s13566-013-0134-3
  2. Effectiveness and Safety of Microvascular Decompression Surgery for Treatment of Trigeminal Neuralgia : A Systematic Review vol.25, pp.4, 2012, https://doi.org/10.1097/scs.0000000000000984
  3. Microvascular decompression surgery: surgical principles and technical nuances based on 4000 cases. vol.36, pp.10, 2012, https://doi.org/10.1179/1743132814y.0000000344
  4. Advances in diagnosis and treatment of trigeminal neuralgia vol.11, pp.None, 2012, https://doi.org/10.2147/tcrm.s37592
  5. A Clinical Analysis of Secondary Surgery in Trigeminal Neuralgia Patients Who Failed Prior Treatment vol.59, pp.6, 2012, https://doi.org/10.3340/jkns.2016.59.6.637
  6. Microvascular Decompression Versus Stereotactic Radiosurgery for Trigeminal Neuralgia: A Decision Analysis vol.9, pp.1, 2012, https://doi.org/10.7759/cureus.1000
  7. Trigeminal Neuralgia vol.12, pp.4, 2012, https://doi.org/10.4103/ajns.ajns_67_14
  8. Stereotactic radiosurgery for trigeminal neuralgia: a systematic review : International Stereotactic Radiosurgery Society practice guidelines vol.130, pp.3, 2012, https://doi.org/10.3171/2017.9.jns17545
  9. Stereotactic radiosurgery for trigeminal neuralgia: a systematic review : International Stereotactic Radiosurgery Society practice guidelines vol.130, pp.3, 2012, https://doi.org/10.3171/2017.9.jns17545
  10. Adverse Events After Microvascular Decompression: A National Surgical Quality Improvement Program Analysis vol.128, pp.None, 2012, https://doi.org/10.1016/j.wneu.2019.05.022