Chen M-J, Shao Z-Y, Zhang W-J, Wang Z-H, Zhang W-H, Hu H-S
Department 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.
Minim Invasive Neurosurg. 2010 Oct;53(5-6):223-8. doi: 10.1055/s-0030-1269926. Epub 2011 Feb 7.
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.
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.
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%).
Similar to other TN radiosurgery reports, X-knife stereotactic radiosurgery for TN provides effective pain relief with a low complication rate.
立体定向放射外科手术对于老年患者以及那些无法耐受用于治疗三叉神经痛（TN）的更具侵入性手术的患者来说是一个有吸引力的选择。在大多数研究中，靶区定位为神经根入区（REZ）的近端神经。本文的目的是评估X刀立体定向放射外科手术治疗TN时对三叉神经节（TG）的疗效及相关并发症。
40例典型特发性TN患者接受了X刀治疗。最大放射剂量为70 Gy。采用4毫米准直器和9弧技术。治疗靶点为TG。
在最后一次随访时（平均随访期：7.9个月，范围：1 - 19个月），所有患者中疼痛缓解情况为优的有16例（40%），良的有17例（42.5%），总成功率为82.8%。首次缓解的平均时间为12.5天，从即刻发作（<24小时）到2个月不等。1例患者（3.0%）出现了一些复发性疼痛。3例患者（7.5%）出现明显的面部主观麻木。1例患者（2.5%）出现听力障碍，2例患者（5%）出现颞部皮肤溃疡。
与其他TN放射外科手术报告相似，X刀立体定向放射外科手术治疗TN可有效缓解疼痛且并发症发生率低。
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