Alperen Sozer, Ozan Yavuz Tufek, Merve Buke Sahin, Mustafa Caglar Sahin, Ozlem Dagli, Alp Ozgun Borcek, Hakan Emmez, Gokhan Kurt, Aydemir Kale, Sukru Aykol, Mesut Emre Yaman
{"title":"放射外科治疗三叉神经痛的前部选择性定位：一项队列研究","authors":"Alperen Sozer, Ozan Yavuz Tufek, Merve Buke Sahin, Mustafa Caglar Sahin, Ozlem Dagli, Alp Ozgun Borcek, Hakan Emmez, Gokhan Kurt, Aydemir Kale, Sukru Aykol, Mesut Emre Yaman","doi":"10.1007/s00701-024-06365-8","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Before commonly used targets such as the Retrogasserian Zone (RGZ) and the Root Entry Zone (REZ) were adopted for the radiosurgical treatment of trigeminal neuralgia (TN), a more anterior target involving the Gasserian ganglion was used. Thanks to advancements in imaging technology, it is now possible to identify and target separate nerve divisions in Meckel’s Cave as desired. Although this approach has been mentioned previously, no clinical study has investigated it until now. This study aims to fill this gap in the literature.</p><h3>Methods</h3><p>Trigeminal neuralgia patients who received radiosurgical treatment between February 2019 and June 2022 in a single centre were included in the study. Pain relief, medication dependency and side effect profiles of the investigated anterior selective target (AST) were compared to those of the classical targets at 1 week, 1–3-6 months, and 1 year.</p><h3>Results</h3><p>A total of 66 patients were included in the study. Effectiveness, safety and application convenience parameters were compared between; the REZ (<i>n</i> = 21), RGZ (<i>n</i> = 20) and AST (<i>n</i> = 25) groups. All groups showed significant improvement in pain with similar results to each other. AST treatments were performed in significantly shorter beam-on-times and with significantly lower brainstem doses.</p><h3>Conclusions</h3><p>The investigated AST showed comparable results to the classical targets without any indication of superiority or inferiority in terms of efficacy and safety in this preliminary investigation. As no blocks were needed to protect the brainstem with this method, it can be used for select patients as needed and could even be investigated in larger studies as an alternative approach.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Anterior selective targeting for radiosurgical treatment of trigeminal neuralgia: a cohort study\",\"authors\":\"Alperen Sozer, Ozan Yavuz Tufek, Merve Buke Sahin, Mustafa Caglar Sahin, Ozlem Dagli, Alp Ozgun Borcek, Hakan Emmez, Gokhan Kurt, Aydemir Kale, Sukru Aykol, Mesut Emre Yaman\",\"doi\":\"10.1007/s00701-024-06365-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Before commonly used targets such as the Retrogasserian Zone (RGZ) and the Root Entry Zone (REZ) were adopted for the radiosurgical treatment of trigeminal neuralgia (TN), a more anterior target involving the Gasserian ganglion was used. Thanks to advancements in imaging technology, it is now possible to identify and target separate nerve divisions in Meckel’s Cave as desired. Although this approach has been mentioned previously, no clinical study has investigated it until now. This study aims to fill this gap in the literature.</p><h3>Methods</h3><p>Trigeminal neuralgia patients who received radiosurgical treatment between February 2019 and June 2022 in a single centre were included in the study. Pain relief, medication dependency and side effect profiles of the investigated anterior selective target (AST) were compared to those of the classical targets at 1 week, 1–3-6 months, and 1 year.</p><h3>Results</h3><p>A total of 66 patients were included in the study. Effectiveness, safety and application convenience parameters were compared between; the REZ (<i>n</i> = 21), RGZ (<i>n</i> = 20) and AST (<i>n</i> = 25) groups. All groups showed significant improvement in pain with similar results to each other. AST treatments were performed in significantly shorter beam-on-times and with significantly lower brainstem doses.</p><h3>Conclusions</h3><p>The investigated AST showed comparable results to the classical targets without any indication of superiority or inferiority in terms of efficacy and safety in this preliminary investigation. As no blocks were needed to protect the brainstem with this method, it can be used for select patients as needed and could even be investigated in larger studies as an alternative approach.</p></div>\",\"PeriodicalId\":7370,\"journal\":{\"name\":\"Acta Neurochirurgica\",\"volume\":\"166 1\",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-11-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Neurochirurgica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s00701-024-06365-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Neurochirurgica","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s00701-024-06365-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Anterior selective targeting for radiosurgical treatment of trigeminal neuralgia: a cohort study
Objective
Before commonly used targets such as the Retrogasserian Zone (RGZ) and the Root Entry Zone (REZ) were adopted for the radiosurgical treatment of trigeminal neuralgia (TN), a more anterior target involving the Gasserian ganglion was used. Thanks to advancements in imaging technology, it is now possible to identify and target separate nerve divisions in Meckel’s Cave as desired. Although this approach has been mentioned previously, no clinical study has investigated it until now. This study aims to fill this gap in the literature.
Methods
Trigeminal neuralgia patients who received radiosurgical treatment between February 2019 and June 2022 in a single centre were included in the study. Pain relief, medication dependency and side effect profiles of the investigated anterior selective target (AST) were compared to those of the classical targets at 1 week, 1–3-6 months, and 1 year.
Results
A total of 66 patients were included in the study. Effectiveness, safety and application convenience parameters were compared between; the REZ (n = 21), RGZ (n = 20) and AST (n = 25) groups. All groups showed significant improvement in pain with similar results to each other. AST treatments were performed in significantly shorter beam-on-times and with significantly lower brainstem doses.
Conclusions
The investigated AST showed comparable results to the classical targets without any indication of superiority or inferiority in terms of efficacy and safety in this preliminary investigation. As no blocks were needed to protect the brainstem with this method, it can be used for select patients as needed and could even be investigated in larger studies as an alternative approach.
期刊介绍：
The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.
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