Gamma Knife Radiosurgery for Intractable Trigeminal Neuralgia - Comparative Study Between Single Versus Two Isocenter...

Area of Science:

• Neurosurgery
• Radiation Oncology
• Pain Management

Background:

• Trigeminal neuralgia (TN) is a debilitating condition causing severe facial pain.
• Gamma Knife Radiosurgery (GKRS) is a treatment option for TN.
• Optimizing GKRS techniques is crucial for improving patient outcomes.

Purpose of the Study:

• To compare the safety and efficacy of single versus two isocenter GKRS for TN.
• To evaluate pain relief and side effect profiles between the two techniques.
• To determine the optimal GKRS target strategy for trigeminal neuralgia.

Main Methods:

• Retrospective study of 171 TN patients treated with GKRS.
• Group A: Single isocenter (90 Gy) at the root entry zone (REZ).
• Group B: Two isocenters (90 Gy) at REZ and distal cisternal segment.

Main Results:

• Group B showed superior pain relief (BNI class I & II) compared to Group A.
• Group B achieved higher rates of pain-free duration.
• Group B had a higher incidence of post-operative facial numbness (27% vs. 14%).

Conclusions:

• Two-isocenter GKRS provides better pain management for TN patients.
• Single isocenter GKRS resulted in fewer side effects.
• Two-isocenter GKRS is a safe and effective alternative with an increased risk of facial hypoesthesia.