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Cyberknife radiosurgery in treating trigeminal neuralgia
  1. Bryan M Lazzara1,
  2. Orlando Ortiz1,
  3. Ritu Bordia1,
  4. Matthew R Witten2,
  5. Jonathan A Haas2,
  6. Alan J Katz2,
  7. Jeffrey A Brown3
  1. 1Department of Radiology, Winthrop-University Hospital, Mineola, New York, USA
  2. 2Department of Radiation Oncology, Winthrop-University Hospital, Mineola, New York, USA
  3. 3Department of Neurosurgery, Winthrop-University Hospital, Mineola, New York, USA
  1. Correspondence to Orlando Ortiz, Chairman, Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA; OOrtiz{at}winthrop.org

Abstract

Purpose To assess the short term efficacy of Cyberknife stereotactic radiosurgical treatment of trigeminal neuralgia (TN).

Methods 17 consecutive patients with medically or surgically refractory unilateral TN were treated with Cyberknife radiosurgery. Using superimposed CT cisternogram and MR images, the target segment of the trigeminal nerve was consistently defined as a 6 mm length of nerve approximately 2–3 mm distal to the dorsal root entry zone of the brainstem. A radiosurgical rhizotomy was performed with the Cyberknife utilizing a single collimator to deliver an average maximum dose of 73.06 Gy (range 72.91–73.73) to the target.

Results Follow-up data were available for 16 of the 17 patients post-treatment (range 1–27 months, average 11.8 months). Overall, 14 of 16 (88%) patients responded favorably with either partial or complete relief of symptomatology. 11 of these patients were successfully free of all pain at some point in their post-treatment course, with seven patients pain free to the last follow-up visit (average 5.0 months, range 1–13 months). Symptoms recurred in four patients, taking place at 3, 7.75, 9 and 18 months after Cyberknife therapy. Only two patients reported side effects. One patient developed a bothersome feathery dysesthesia while the second patient reported a non-bothersome mild jaw hypoesthesia. There were no substantial complications related to stereotactic radiosurgery.

Conclusion Cyberknife radiosurgery is a viable treatment alternative in patients with TN with competitive efficacy demonstrated in our group of patients while minimizing adverse effects.

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Footnotes

  • Competing interests None.

  • Ethics approval This was a retrospective review of short term treatment outcomes with patient data recorded in a non-identifiable manner. A standard Health Insurance Portability and Accountability Act compliant protocol was followed.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available on request.

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