Outcome of Gamma Knife radiosurgery for trigeminal neuralgia associated with neurovascular compression

Chang, Cheng-Chen; Huang, Cheng-Wei; Chou, His-Hsien; Lin, Long-Yau; Huang, Chin-Shiu

doi:10.1016/j.jocn.2017.09.016

Cited by 11 publications

(9 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, there is no standard technology to deal with the VBD-TN. Drug treatment is the preferred treatment, but when the pain is out of control, other forms of treatment are needed, such as MVD [4,9], peripheral nerve resection [33], peripheral nerve alcohol injection[28], percutaneous glycerol lesions [16,44], percutaneous balloon compression [3,6], GKRS [11,49] and radiofrequency thermocoagulation [21,35]. MVD and GKRS are the more common treatment methods used in clinical practice nowadays due to acquiring good painrelief outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…GKRS is a minimally invasive radiotherapy for the treatment of VBD-TN. According to the number of targets in the radiology, it can be divided into single isocenter [42], two isocenters [39] and multiple isocenters [11]. The bene ts of GKRS for primary TN have been recognized, furthermore, many patients with recurrent pain can relieve pain effectively after receiving the second GKRS treatment [10,14,37].…”

Section: Discussionmentioning

confidence: 99%

“…Trigeminal neuralgia (TN) is mainly characterized by recurrent paroxysmal electric shock-like and acupuncture-like pain in the distribution area of the trigeminal nerve that composed of the eye branch (V1), the maxillary branch (V2), and the mandibular branch (V3), which usually lasts for a few seconds [11,37,47]. The actions, including brushing teeth, gargle, washing face, chewing, and other activities, especially when eating cold or hot food, can induce TN.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of microvascular decompression and two isocenters gamma knife for the treatment of trigeminal neuralgia caused by vertebrobasilar compression

Zhao

Chai

Wang

et al. 2021

Preprint

View full text Add to dashboard Cite

Objective: Vertebrobasilar dolichoectasia (VBD) is one of the uncommon causes of trigeminal neuralgia (TN). The main surgical treatments for TN caused by VBD (VBD-TN) are invasive microvascular decompression (MVD) and mini-invasive Gamma Knife radiosurgery (GKRS). However, the therapeutic effects of the two methods have not been clinically reported, so this study evaluated the outcomes of MVD and GKRS for patients with VBD-TN.Methods: The retrospective study of patients diagnosed with VBD-TN in Wuhan Union Hospital was performed from March 2011 to March 2019. A total of 80 patients were included in this study, and they were divided into the MVD group (n = 46) and GKRS group (n = 34) according to the surgical methods. Among patients in the GKRS group, all performed by two isocenters gamma knife. The imaging data, intraoperative findings, outcomes, and complications of the two groups were analyzed and compared.Results: Patients who underwent MVD were younger than patients who underwent GKRS (median ages were 61.1 and 65.4 years old, p=0.03). The average follow-up was 61.1 months for the MVD group and was 56.8 months for the GKRS group. The favorable outcomes (BNI score I-II) occurred in 97.8% of patients treated with MVD and in 78.9% of patients treated with GKRS (P=0.009). The favorable outcomes in the percentage of patients after MVD 1,3,5 and 7 years were 95.7%, 85.1%, 74.2%, and 74.2%. The corresponding percentages after GKRS were 76.5%, 66.2%, 56.6% and 47.2%, respectively (P=0.031). The postoperative complications (except facial numbness) in the MVD group were higher than those in the GKRS group (P=0.036), but the incidence of new and worsening facial numbness was higher in the GKRS group (P<0.001).Conclusions: For VBD-TN, MVD is superior to GKRS in obtaining and maintaining favorable outcomes, but it also comes with more complications other than facial sensation. Treatment choice can be tailored to a patient’s unique condition and wishes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of microvascular decompression and two isocenters gamma knife for the treatment of trigeminal neuralgia caused by vertebrobasilar compression

Zhao

Chai

Wang

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…27 In another study, after long-term follow-up, although the proportion of patients with NVC who had good outcomes was higher than that of patients without NVC, there was no statistical difference between the two groups (86.4% and 68.0%, respectively). 28 Chang et al 29 found that there was no significant difference in successful pain control rates (BNI score I-III) among patients with different NVC conditions after GKRS treatment (successful pain control rate, no NVC 85%, small vessel NVC 75%, large vessel NVC 88%, respectively). However, a large proportion of patients will experience facial numbness after receiving GKRS.…”

Section: Discussionmentioning

confidence: 99%

<p>The Long-Term Outcomes and Predictors of Microvascular Decompression with or without Partial Sensory Rhizotomy for Trigeminal Neuralgia</p>

Liu¹,

Deng²,

Zhang³

et al. 2020

JPR

View full text Add to dashboard Cite

Microvascular decompression (MVD) and MVD combined with partial sensory rhizotomy (PSR) are effective surgical treatments for idiopathic trigeminal neuralgia (TN). The aim of this study was to compare the long-term outcomes of both MVD and MVD+PSR for the treatment of TN and to identify the factors that may influence the long-term outcomes after MVD or MVD+PSR. Patients and Methods: From March 2009 to December 2017, 99 patients with idiopathic TN who underwent MVD or MVD+PSR in our hospital (40 MVD, 59 MVD+PSR) were included in the study. The indications for MVD+PSR were as follows: vessels only contacted the nerve root, absence of arterial conflict, or failing to completely decompress from the arteries or veins. All patients were treated by one neurosurgeon and were followed up for at least 1 year. The outcomes were assessed with the Barrow Neurological Institute (BNI) Pain Intensity Scale. Results: The average follow-up duration was 63.0 months (range, 13.2-118.8 months). Patients in the MVD group were younger than those in the MVD+PSR group (55.1 years and 60.5 years, respectively, P=0.012). A total of 62.5% of the patients in the MVD group and 69.5% of the patients in the MVD+PSR group had favorable long-term outcomes. The Kaplan-Meier survival analysis showed no significant difference in long-term outcomes between the two groups (P=0.202). No factors were associated with long-term outcomes after MVD. For MVD+PSR, a long duration of the disease (odds ratio (OR) 6.967, P=0.016) was associated with unfavorable long-term outcomes, whereas pure arterial compression (OR 0.131, P=0.013) was associated with favorable long-term outcomes. Conclusion: For patients who are not suitable to undergo pure MVD, MVD+PSR can be used as an effective alternative. For MVD+PSR, patients with a long duration of symptoms may have poor long-term outcomes, while patients with pure arterial compression may have favorable long-term outcomes.

show abstract

“…Trigeminal neuralgia (TN) is mainly characterized by recurrent paroxysmal electric shock-like or acupuncture-like pain in the distribution area of the trigeminal nerve that is composed of the eye branch (V1), the maxillary branch (V2), and the mandibular branch (V3), which usually lasts for a few seconds (1)(2)(3). The actions, including brushing teeth, gargling, washing face, chewing, and other activities, especially eating cold or hot food, can induce TN.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Microvascular Decompression and Two Isocenters Gamma Knife for the Treatment of Trigeminal Neuralgia Caused by Vertebrobasilar Dolichoectasia

et al. 2021

View full text Add to dashboard Cite

Background: Vertebrobasilar dolichoectasia (VBD) is one of the rare causes of trigeminal neuralgia (TN). The common surgical treatments for patients with TN caused by VBD (VBD-TN) are microvascular decompression (MVD) and Gamma Knife radiosurgery (GKRS). However, the therapeutic effects of the two methods have not been clinically compared, so this study was performed to evaluate the treatment outcomes of MVD and GKRS for patients with VBD-TN.Methods: The retrospective study was performed from March 2011 to March 2019 in Wuhan Union Hospital. A total of 80 patients diagnosed with VBD-TN were included in this study, and they were divided into the MVD group (n = 46) and GKRS group (n = 34) according to the surgical methods. The imaging data, intraoperative findings, treatment outcomes, and complications of the two groups were analyzed and compared. Meanwhile, the influencing factors of the treatment effect are also explored on the two groups.Results: Patients who underwent MVD were younger than patients who underwent GKRS (median ages were 61.1 and 65.4 years old, respectively, p = 0.03). The median follow-up was 61.1 months for the MVD group and 56.8 months for the GKRS group. The favorable outcomes [Barrow Neurological Institute (BNI) pain score, BNI scores I–II] occurred in 97.8% of patients treated with MVD and in 78.9% of patients treated with GKRS (p = 0.009). The favorable outcomes in the percentage of patients after MVD 1, 3, 5, and 7 years were 95.7, 85.1, 74.2, and 74.2%, respectively, whereas the corresponding percentages after GKRS were 76.5, 66.2, 56.6, and 47.2%, respectively (p = 0.031). The postoperative complications (except facial numbness) in the MVD group were higher than those in the GKRS group (p = 0.036), but the incidence of new and worsening facial numbness was lower in the GKRS group (p < 0.001).Conclusions: MVD is superior to GKRS in obtaining and maintaining favorable outcomes for patients with VBD-TN, but it also comes with more complications other than facial numbness. Thus, the treatment program can be tailored to a patient's unique condition and wishes.

show abstract

Outcome of Gamma Knife radiosurgery for trigeminal neuralgia associated with neurovascular compression

Cited by 11 publications

References 17 publications

Comparison of microvascular decompression and two isocenters gamma knife for the treatment of trigeminal neuralgia caused by vertebrobasilar compression

Comparison of microvascular decompression and two isocenters gamma knife for the treatment of trigeminal neuralgia caused by vertebrobasilar compression

<p>The Long-Term Outcomes and Predictors of Microvascular Decompression with or without Partial Sensory Rhizotomy for Trigeminal Neuralgia</p>

Comparison of Microvascular Decompression and Two Isocenters Gamma Knife for the Treatment of Trigeminal Neuralgia Caused by Vertebrobasilar Dolichoectasia

Contact Info

Product

Resources

About