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Minim Invasive Neurosurg 2010; 53(5/06): 223-228
DOI: 10.1055/s-0030-1269926
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

X-Knife Stereotactic Radiosurgery on the Trigeminal Ganglion to Treat Trigeminal Neuralgia: A Preliminary Study

M.-J. Chen1 , 3 , Z.-Y. Shao2 , 3 , W.-J. Zhang1 , Z.-H. Wang2 , W.-H. Zhang1 , H.-S. Hu2
  • 1Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China
  • 2Division of Radiation Therapy, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
  • 3Dr. Min-jie Chen and Dr. Zi-yang Shao contributed equally to this work
Further Information

Publication History

Publication Date:
07 February 2011 (online)

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Abstract

Background: Stereotactic radiosurgery is an attractive option for elderly patients and those who do not tolerate the more invasive surgical procedures available for trigeminal neuralgia (TN). In the majority of the studies, the target location was designated as the proximal nerve at the root entry zone (REZ). The purpose of this article was to evaluate the efficacy of and complications associated with X-knife stereotactic radiosurgery on the trigeminal ganglion (TG) for TN.

Patients and Methods: 40 patients with typical idiopathic TN were treated with X-knife. The maximum radiation dose was 70 Gy. A 4-mm collimator and a 9-arc technique were employed. Treatment was focused at the TG.

Results: At the last follow-up (mean follow-up period: 7.9 months, range: 1–19 months), pain relief for all patients was excellent in 16 (40%), good in 17 (42.5%), for a total success rate of 82.8%. The mean time to initial relief was 12.5 days ranging from immediate in onset (<24 h) to 2 months. One patient (3.0%) experienced some recurrent pain. 3 patients (7.5%) experienced noticeable subjective facial numbness. Hearing impairment was found in 1 patient (2.5%), and ulceration of the temporal skin was seen in 2 patients (5%).

Conclusion: Similar to other TN radiosurgery reports, X-knife stereotactic radiosurgery for TN provides effective pain relief with a low complication rate.

Key words

X-knife - radiofrequency thermocoagulation - trigeminal ganglion - trigeminal neuralgia

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Correspondence

W.-J. ZhangMD 

Department of Oral and

Maxillofacial Surgery

Ninth People's Hospital

Shanghai Jiao Tong University

School of Medicine

Shanghai Key Laboratory of

Stomatology

No. 639 Zhi-zao-ju Road

200011 Shanghai

People's Republic of China

Phone: +86/021/2327 1699 5388

Fax: +86/021/5307 2423

Email: chenminjie00@126.com