Gorgulho Alessandra A, De Salles Antonio A F
Division of Neurosurgery, David Geffen School of Medicine at UCLA, University of California at Los Angeles (UCLA), Los Angeles, CA 90095, USA.
Surg Neurol. 2006 Oct;66(4):350-6. doi: 10.1016/j.surneu.2006.03.046.
The history of the development of current available techniques to treat TN was reviewed.
The largest peer-reviewed publications on the surgical treatment of refractory TN were analyzed, considering the pros and cons of each technique. Results of modern peer-reviewed radiosurgery series were presented, taking into consideration the approach of each research article. Radiation doses and targets for radiosurgery were discussed to maximize the understanding of this technique.
It is concluded that radiosurgery is the least invasive modality with the fewest side effects, although, to match the results of the competing techniques, a substantial number of patients still need some medication intake.
Further studies determining the ideal target and radiation dose may bring radiosurgery results to the level of the ones achieved with microvascular decompression, currently considered the gold-standard method.
回顾了当前可用的治疗三叉神经痛(TN)技术的发展历程。
分析了关于难治性TN外科治疗的最大规模同行评审出版物,考量了每种技术的优缺点。展示了现代同行评审的放射外科系列研究结果,同时考虑了每篇研究文章的方法。讨论了放射外科的辐射剂量和靶点,以加深对该技术的理解。
得出结论,放射外科是侵入性最小、副作用最少的治疗方式,不过,为了达到其他竞争技术的治疗效果,仍有相当数量的患者需要服用一些药物。
进一步确定理想靶点和辐射剂量的研究可能会使放射外科的治疗效果达到微血管减压术(目前被视为金标准方法)的水平。