Gamma Knife Treatment of Pain Syndromes of the Glossopharyngeal Area

Česká verzia

Authors: D. Urgošík; R. Liščák
Authors place of work: Oddělení stereotaktické a radiační neurochirurgie, Nemocnice Na Homolce, Praha
Published in the journal: Cesk Slov Neurol N 2016; 79/112(3): 331-335
Category: Short Communication
doi: https://doi.org/10.14735/amcsnn2016331

Summary

Patients and Methods:
We used Gamma Knife (dose of 80 Gy) to irradiate inferior glossopharyngeal ganglion in 12 patients. Six patients had typical glossopharyngeal neuralgia (GFN), 3 had a combination of GFN and neuralgia in the 3^rd branch of the trigeminal nerve (GFN_TN) and 3 had secondary pain in glossopharyngeal area (F : M = 9 : 3; mean age 61.5 years, SD ± 9.7; follow-up 6–120 months, median 76.5). Pain relief was assessed using Barrow Neurological Institute (BNI) scores and side effects by neurological examination.

Results:
We achieved successful pain relief (BNI I–III) in eight patients of the nine GFN and GFN_TN patients (88.8%). Complete pain relief (BNI I and II) was observed in six patients (75%) and treatment failed in one patient. Three patients with secondary pain had no pain relief. Recurrent pain in glossopharyngeal area occurred in two (25%) patients. “False” relapses in the untreated area of the 3^rd branch of the trigeminal nerve manifested in GFN_TN. Second irradiation of the inferior ganglion in GFN patients (two with recurrence and one with unsatisfactory response) and radiation of the trigeminal nerve in GFN_TN patients (two patients with “false” relapses) led to complete pain relief (BNI I and II ). In total, first and second irradiation was successful in all nine patients with GFN and GFN_TN.

Conclusion:
Gamma knife is an additional treatment option in patients with GFN with a good chance for relief and with minimal side-effects.

Key words:
gamma knife – radiosurgery – glossopharyngeal neuralgia – trigeminal neuralgia

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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