Gamma-Knife radiosurgery for the treatment of trigeminal neuralgia: A single center experience.

The aim of this study is to assess the results and outcome of a series of patients with trigeminal neuralgia (TGN) and underwent gamma knife radiosurgery (GKRS). Fifty-three patients with symptoms of typical TGN were operated from May 2012 until December 2022. Among these patients, 45 patients were included to the study, who have at least 12 months of follow-up. A mean dose of 87.5 Gy (range 80-90) was delivered to the trigeminal nerve. Postoperatively, outcome was assessed as being excellent when the patient was pain free and medication free. The mean duration of the symptoms was 9.53 years and the mean age was 59.8 (range 34 to 85). The mean follow-up period was 46.8 months (range 12 to 127 months). 46.7% of patients had a history of previous surgical interventions, in 14 patients (31.1%) a single trigeminal division was affected, whereas in the other 31 patients (68.9%) multiple divisions were affected. The rate of initial pain relief was 80%. Hypoesthesia of the trigeminal nerve occurred in 30 (66.7%) of the cases. 20 patients (44.4%) showed excellent results with a mean follow-up period of 72.4 months. Recurrence occurred in 11 patients (24.4%) by a mean time of 27.6 months. Our results suggest that gamma knife radiosurgery is a safe and efficacious procedure. As such, it is an attractive first- and second-line choice in the treatment of trigeminal neuralgia.

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