title: X-knife stereotactic radiosurgery on the trigeminal ganglion to treat trigeminal neuralgia: a preliminary study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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%).
  
  
  CONCLUSIONS
  Similar to other TN radiosurgery reports, X-knife stereotactic radiosurgery for TN provides effective pain relief with a low complication rate.
authors.affiliation: 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.
authors.forename: M-J
authors.initials: MJ
authors.lastname: Chen
authors.forename: Z-Y
authors.initials: ZY
authors.lastname: Shao
authors.forename: W-J
authors.initials: WJ
authors.lastname: Zhang
authors.forename: Z-H
authors.initials: ZH
authors.lastname: Wang
authors.forename: W-H
authors.initials: WH
authors.lastname: Zhang
authors.forename: H-S
authors.initials: HS
authors.lastname: Hu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D011829:Radiation Dosage; D016634:Radiosurgery / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D012668:Trigeminal Ganglion / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000601:surgery*