J Neurosurg 142:1134–1140, 2025
The study investigates predictors of trigeminal neuropathy (Tn) in patients receiving Gamma Knife stereotactic radiosurgery for vestibular schwannoma. It identifies the volume of cranial nerve V receiving ≥11 Gy as a significant factor in Tn development, suggesting it be included in dosimetric planning to minimize risk.
• Objective: Validate predictors of trigeminal neuropathy (Tn) in patients receiving stereotactic radiosurgery (SRS) for vestibular schwannoma (VS).
• Methodology: Study included 204 patients treated with SRS, excluding those with pre-existing Tn symptoms or less than 2 years of follow-up.
• Key Finding: The volume of cranial nerve (CN) V receiving ≥ 11 Gy is the only significant predictor of Tn development post-SRS.
• Results: 11.3% of patients developed Tn, with 7.8% experiencing permanent symptoms.
• Statistical Analysis: Maximum dose to CN V was significant in univariate analysis but not in multivariate analysis.
• Tumor Compression: Not significantly correlated with Tn development.
• Clinical Implication: Dosimetric planning should account for CN V volume receiving ≥ 11 Gy to minimize Tn risk.
• Recommendation: Early treatment advised to maintain gap between VS and CN V, reducing Tn risk.
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