Publication year: 2012
Source:World Neurosurgery
Shota Tanaka, Bruce E. Pollock, Scott L. Stafford, Michael J. Link
Objective To assess the outcome of stereotactic radiosurgery (SRS) for patients with benign skull base tumors and trigeminal-related facial pain. Methods Retrospective review of 31 consecutive patients (25 women, 6 men) with benign skull base tumors and trigeminal pain undergoing 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). In all cases the tumor was the primary target for SRS. The median follow-up after SRS was 50 months (range, 12-184). Results The 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%). Conclusion Although 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.
Júlio Leonardo B. Pereira
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