Trigeminal neuralgia radiosurgery: the University of Pittsburgh experience.
Trigeminal neuralgia radiosurgery: the University of Pittsburgh experience.
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三叉神经痛放射外科：匹兹堡大学的经验。
DOI：
10.1159/000099734
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发表时间：
1996
影响因子：
1.7
通讯作者：
M. Habeck
中科院分区：
文献类型：
--
作者：
D. Kondziolka;J. Flickinger;Lunsford Ld;M. Habeck
在匹兹堡大学对51例典型三叉神经痛患者进行伽玛刀立体定向放射外科治疗。在所有病例中，4 mm等中心定位于近端神经的根入区。靶区剂量为60~90Gy.44名患者(86%)曾接受过手术。放射外科术后平均随访9.6个月(2~29个月)。初步有效率为86%。最后一次随访时，19例(37%)患者控制良好(无疼痛)，21例(41%)控制良好(50%~90%缓解)，11例(21%)治疗失败。没有患者出现进一步的感觉丧失或去传入疼痛。最大放射外科剂量或=70GY与完全缓解疼痛的机会显著增加相关。利用磁共振成像立体定向靶点，三叉神经近端是合适的放射外科解剖靶点。伽玛刀放射外科是治疗内科或外科难治性三叉神经痛的有效辅助手术方法。
The results of Gamma Knife stereotactic radiosurgery in the management of 51 patients who had typical trigeminal neuralgia were evaluated at the University of Pittsburgh. In all cases, a 4-mm isocenter was targeted at the proximal nerve at the root entry zone. The target dose varied from 60 to 90 Gy. Forty-four patients (86%) had undergone prior surgery. The mean follow-up after radiosurgery was 9.6 months (range, 2-29 months). The initial response rate was 86%. At the last follow-up, 19 patients (37%) had excellent control (pain free), 21 (41%) had good control (50-90% relief), and 11 (21%) had failed treatment. No patient developed further sensory loss or deafferentation pain. A maximum radiosurgery dose > or = 70 Gy was associated with a significantly greater chance for complete pain relief. Using magnetic resonance imaging stereotactic targeting, the proximal trigeminal nerve is an appropriate anatomic target for radiosurgery. Gamma Knife radiosurgery is a useful additional surgical approach in the management of medically or surgically refractory trigeminal neuralgia.