• Hongyang Zhao, Yin Shen, Dongxiao Yao, Nanxiang Xiong, Ahmed Abdelmaksoud, and Haijun Wang.
• Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Huazhong, Hubei Province, China.
• World Neurosurg. 2018 Jan 1; 109: e531-e538.

ObjectiveTo evaluate the effectiveness and safety of 2-isocenter Gamma Knife surgery (GKS) by reviewing patients with trigeminal neuralgia (TN) from the last 10 years.MethodsA total of 247 patients were followed up and the Barrow Neurological Institute scale was used to evaluate pain degree. Patients' age, gender, pain duration and location, preoperative/postoperative Barrow Neurological Institute scale score, time to initial pain relief, recurrence time, and complications were documented and analyzed.ResultsPatients who underwent a 2-isocenter GKS achieved earlier initial pain relief. The median time of initial pain relief was 2.0 months. Kaplan-Meier analysis showed that the patients with a shorter history of TN and the patients without preoperative surgery achieved earlier initial pain relief. During the 122.8 months of follow-up, the median time of recurrence-free pain relief was 49.7 months. Age was found to be a risk factor of recurrence. Patients who underwent 2-isocenter GKS had a higher rate of postoperative facial numbness, but only 9 cases reported bothersome facial numbness. Multibranch involvement was a risk factor for postoperative facial numbness.ConclusionsCompared with other modalities, 2-isocenter GKS was a safe and highly effective option for patients with TN. However, more data need to be collected to verify its long-term effect.Copyright © 2017 Elsevier Inc. All rights reserved.

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