Long-Term Patient-Reported Outcomes of Stereotactic Radiosurgery for Trigeminal Neuralgia.

BACKGROUND: We aimed to evaluate patient-reported outcomes (PROs) of stereotactic radiosurgery (SRS) for TN in terms of treatment efficacy and toxicity. METHODS: We retrospectively analyzed patients who u nderwent Gamma Knife SRS for idiopathic or classic TN between January 2013 and February 2022. Questionnaires regarding pain relief, treatment toxicity, and post -SRS treatment were sent between late 2022 and early 2023, and the responses received were analyzed. The Faces Pain Scale (FPS, 0: best, 5: worst) was used for quantitative evaluation. RESULTS: Responses were received from 51 patients (76%). The mean pre-SRS FPS score was 4.1 (standard deviation (SD) 1.1). Forty-three patients (83%) reported initial pain relief and the best post -SRS FPS score was 1.1 (SD 1.5) ( P < 0.001). At a median follow-up of 50 months, the FPS score was still 1.1 (SD 1.6) ( P < 0.001). Analysis of factors contributing to durable pain relief showed neurovascular compression to be associated with FPS score improvement (Odds ratio 5.7, 95% CI 1.1 e29.7, P = 0.038). Facial dysesthesia had a mean pre-SRS FPS score of 1.7 (SD 2.0) and a mean score of 1.4 (SD 1.7) at the last followu p ( P = 0.32). Eight patients (15%) received post -SRS interventions and 21 (40%) no longer required pharmacotherapy without post -SRS intervention. Forty-four patients (85%) reported being satisfied with SRS. CONCLUSIONS: We analyzed PROs of SRS for TN using the FPS and showed SRS to be a safe and effective treatment modality achieving long lasting pain relief.