Elaimy Ameer L, Hanson Peter W, Lamoreaux Wayne T, Mackay Alexander R, Demakas John J, Fairbanks Robert K, Cooke Barton S, Thumma Sudheer R, Lee Christopher M
Gamma Knife of Spokane, 910 W 5th Avenue, Suite 102, Spokane, WA 99204, USA.
Int J Otolaryngol. 2012;2012:919186. doi: 10.1155/2012/919186. Epub 2011 Oct 25.
Since its introduction by Leksell, Gamma Knife radiosurgery (GKRS) has become increasingly popular as a management approach for patients diagnosed with trigeminal neuralgia (TN). For this reason, we performed a modern review of the literature analyzing the efficacy of GKRS in the treatment of patients who suffer from TN. For patients with medically refractory forms of the condition, GKRS has proven to be an effective initial and repeat treatment option. Cumulative research suggests that patients treated a single time with GKRS exhibit similar levels of facial pain control when compared to patients treated multiple times with GKRS. However, patients treated on multiple occasions with GKRS are more likely to experience facial numbness and other facial sensory changes when compared to patients treated once with GKRS. Although numerous articles have reported MVD to be superior to GKRS in achieving facial pain relief, the findings of these comparison studies are weakened by the vast differences in patient age and comorbidities between the two studied groups and cannot be considered conclusive. Questions remain regarding optimal GKRS dosing and targeting strategies, which warrants further investigation into this controversial matter.
自Leksell引入伽玛刀放射外科手术（GKRS）以来，它作为一种治疗三叉神经痛（TN）患者的管理方法越来越受欢迎。因此，我们对文献进行了一项现代综述，分析了GKRS在治疗TN患者中的疗效。对于药物难治性形式的患者，GKRS已被证明是一种有效的初始和重复治疗选择。累积研究表明，与多次接受GKRS治疗的患者相比，单次接受GKRS治疗的患者在面部疼痛控制水平上相似。然而，与单次接受GKRS治疗的患者相比，多次接受GKRS治疗的患者更有可能出现面部麻木和其他面部感觉变化。尽管许多文章报道微血管减压术（MVD）在实现面部疼痛缓解方面优于GKRS，但这些比较研究的结果因两个研究组患者年龄和合并症的巨大差异而受到削弱，不能被视为定论。关于最佳GKRS剂量和靶向策略的问题仍然存在，这值得对这一有争议的问题进行进一步研究。
