Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other Procedures
Objectives Trigeminal neuralgia (TN) is undurable paroxysmal pain in the distribution of the fifth cranial nerve. Invasive treatment modalities for TN include microvascular decompression (MVD) and percutaneous procedures, such as, radiofrequency rhizotomy (RFR). Gamma Knife radiosurgery (GKRS) is a...
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| Format: | Article |
| Language: | English |
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Kosin University College of Medicine
2019-06-01
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| Series: | Kosin Medical Journal |
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| Online Access: | http://www.kosinmedj.org/upload/pdf/ksmc034-01-04.pdf |
| _version_ | 1811255693808762880 |
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| author | Jae Meen Lee Beong Ik Hur Chang Hwa Choi |
| author_facet | Jae Meen Lee Beong Ik Hur Chang Hwa Choi |
| author_sort | Jae Meen Lee |
| collection | DOAJ |
| description | Objectives Trigeminal neuralgia (TN) is undurable paroxysmal pain in the distribution of the fifth cranial nerve. Invasive treatment modalities for TN include microvascular decompression (MVD) and percutaneous procedures, such as, radiofrequency rhizotomy (RFR). Gamma Knife radiosurgery (GKRS) is a considerable option for patients with pain recurrence after an initial procedure. This study was undertaken to analyze the effects of gamma knife radiosurgery in recurrent TN after other procedures. Methods Eleven recurrent TN patients after other procedures underwent GKRS in our hospital from September 2004 to August 2016. Seven patients had previously undergone MVD alone, two underwent MVD with partial sensory rhizotomy (PSR), and two underwent RFR. Mean patient age was 60.5 years. We retrospectively analyzed patient's characteristics, clinical results, sites, and divisions of pain. Outcomes were evaluated using the Visual Analog Scales (VAS) score. Results Right sides were more prevalent than left sides (7:4). The most common distribution of pain was V1 + V2 division (n = 5) following V2 + V3 (n = 3), V2 (n = 2), and V1 + V2 + V3 (n = 1) division. Median GKRS dose was 80 Gy and the mean interval between the prior treatment and GKRS was 74.45 months. The final outcomes of subsequent GKRS were satisfactory in most cases, and at 12 months postoperatively ten patients (90.0%) had a VAS score of ≤ 3. Conclusions In this study, the clinical result of GKRS was satisfactory. Invasive procedures, such as, MVD, RFR are initially effective in TN patients, but GKRS provides a safe and satisfactory treatment modality for those who recurred after prior invasive treatments. |
| first_indexed | 2024-04-12T17:28:29Z |
| format | Article |
| id | doaj.art-c93c9bb683104b1bb4db879782518890 |
| institution | Directory Open Access Journal |
| issn | 2005-9531 |
| language | English |
| last_indexed | 2024-04-12T17:28:29Z |
| publishDate | 2019-06-01 |
| publisher | Kosin University College of Medicine |
| record_format | Article |
| series | Kosin Medical Journal |
| spelling | doaj.art-c93c9bb683104b1bb4db8797825188902022-12-22T03:23:12ZengKosin University College of MedicineKosin Medical Journal2005-95312019-06-01341303710.7180/kmj.2019.34.1.30100Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other ProceduresJae Meen Lee0Beong Ik Hur1Chang Hwa Choi2Department of Neurosurgery, Pusan National University Hospital, Busan, .KoreaDepartment of Neurosurgery, Pusan National University Hospital, Busan, .KoreaDepartment of Neurosurgery, Pusan National University Hospital, Busan, .KoreaObjectives Trigeminal neuralgia (TN) is undurable paroxysmal pain in the distribution of the fifth cranial nerve. Invasive treatment modalities for TN include microvascular decompression (MVD) and percutaneous procedures, such as, radiofrequency rhizotomy (RFR). Gamma Knife radiosurgery (GKRS) is a considerable option for patients with pain recurrence after an initial procedure. This study was undertaken to analyze the effects of gamma knife radiosurgery in recurrent TN after other procedures. Methods Eleven recurrent TN patients after other procedures underwent GKRS in our hospital from September 2004 to August 2016. Seven patients had previously undergone MVD alone, two underwent MVD with partial sensory rhizotomy (PSR), and two underwent RFR. Mean patient age was 60.5 years. We retrospectively analyzed patient's characteristics, clinical results, sites, and divisions of pain. Outcomes were evaluated using the Visual Analog Scales (VAS) score. Results Right sides were more prevalent than left sides (7:4). The most common distribution of pain was V1 + V2 division (n = 5) following V2 + V3 (n = 3), V2 (n = 2), and V1 + V2 + V3 (n = 1) division. Median GKRS dose was 80 Gy and the mean interval between the prior treatment and GKRS was 74.45 months. The final outcomes of subsequent GKRS were satisfactory in most cases, and at 12 months postoperatively ten patients (90.0%) had a VAS score of ≤ 3. Conclusions In this study, the clinical result of GKRS was satisfactory. Invasive procedures, such as, MVD, RFR are initially effective in TN patients, but GKRS provides a safe and satisfactory treatment modality for those who recurred after prior invasive treatments.http://www.kosinmedj.org/upload/pdf/ksmc034-01-04.pdfgamma knife radiosurgeryrecurrent trigeminal neuralgiavisual analog scale score |
| spellingShingle | Jae Meen Lee Beong Ik Hur Chang Hwa Choi Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other Procedures Kosin Medical Journal gamma knife radiosurgery recurrent trigeminal neuralgia visual analog scale score |
| title | Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other Procedures |
| title_full | Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other Procedures |
| title_fullStr | Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other Procedures |
| title_full_unstemmed | Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other Procedures |
| title_short | Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other Procedures |
| title_sort | gamma knife radiosurgery in recurrent trigeminal neuralgia after other procedures |
| topic | gamma knife radiosurgery recurrent trigeminal neuralgia visual analog scale score |
| url | http://www.kosinmedj.org/upload/pdf/ksmc034-01-04.pdf |
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