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http://dx.doi.org/10.3340/jkns.2012.51.5.276

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)
Publication Information
Journal of Korean Neurosurgical Society / v.51, no.5, 2012 , pp. 276-280 More about this Journal
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.
Keywords
Trigeminal neuralgia; Gamma knife radiosurgery; Long-term follow-up;
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