相澤病院における特発性三叉神経痛に対するガンマナイフ治療
スポンサーリンク
概要
- 論文の詳細を見る
The purpose of this retrospective study was to better understand the outcome of gamma knife radiosurgery in patients with idiopathic trigeminal neuralgia. Between April 2003 and August 2009, 35 patients with idiopathic trigeminal neuralgia in whom medication with carbamazepin was not effective were treated with gamma knife raidosurgery for the first time at Aizawa Hospital. Of these 35 patients, 12 were men and 23 were women. The median age was 69.8 years (range 46-86 years). Pain was predominantly distributed in the V2 and V3 divisions. Under local anesthesia, all radiosurgical procedures were performed with the aid of Gamma Unit Model B, and stereotactic MR imaging (heavy T2 and time-of-flight) was performed to identify the trigeminal nerve. A single 4-mm isocenter was used in all patients, and the target was placed between the root entry zone and retrogasserian region. The central radiation dose was 80 Gy or 85 Gy. The median follow-up period was 45.6 months (range 13-90 months).Complete pain relief with or without medication was achieved in 75.8% at 1 year, 68% at 2 years, 64.7% at 3 years, 57.1% at 4 years, and 55.6% at 5 years. Pain relief was not achieved at all in a patient whose trigeminal nerve was difficult to identify. One patient, who was treated with a central dose of 85 Gy, complained of bothersome facial numbness.Although the long-term results of pain relief remain unknown and gamma knife radiosurgery should be performed in carefully selected patients, the results of this study suggest that gamma knife radiosurgery is a safe and effective treatment for idiopathic refractory trigeminal neuralgia.
- 信州医学会の論文