• World Neurosurg · Sep 2013

    Case Reports

    Stereotactic radiosurgery for trigeminal pain secondary to benign skull base tumors.

    • Shota Tanaka, Bruce E Pollock, Scott L Stafford, and Michael J Link.
    • Department of Neurologic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
    • World Neurosurg. 2013 Sep 1;80(3-4):371-7.

    ObjectiveTo assess the outcome of stereotactic radiosurgery (SRS) for patients with benign skull base tumors and trigeminal-related facial pain.MethodsWe undertook a retrospective review of 31 consecutive patients (25 women, 6 men) with benign skull base tumors and trigeminal pain who underwent SRS between 1991 and 2008. The tumors included 17 posterior fossa meningiomas, 9 cavernous sinus meningiomas, and 5 trigeminal schwannomas. The median patient age was 62 years (range, 17-81 years). In all cases the tumor was the primary target for SRS. The median follow-up after SRS was 50 months (range, 12-184 months).ResultsThe actuarial tumor control rate after SRS was 95% at both 3 years and 5 years. Eighteen patients (58%) initially achieved complete resolution of trigeminal pain. Higher maximum dose was associated with initial complete pain resolution on a multivariate analysis. However, 7 patients had recurrent pain during follow-up. At last follow-up, only 7 patients (23%) remained pain-free off medications. Further treatment in addition to medical therapy was required for 6 patients (19%).ConclusionAlthough SRS offers excellent radiographic tumor control for benign skull base tumors, durable relief of tumor-related trigeminal pain without medication was noted in only one-fourth of patients at last follow-up.Copyright © 2013 Elsevier Inc. All rights reserved.

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