Efficacy and safety of stereotactic radiosurgery for idiopathic glossopharyngeal neuralgia: A systematic review and meta-analysis.

BACKGROUND

We performed this study to comprehensively assess the efficacy and safety of stereotactic radiosurgery (SRS) in patients with glossopharyngeal neuralgia (GPN).

METHODS

Searches of PubMed, Embase, Cochrane Library, and Web of Science were performed from inception to date. The protocol for this study was registered with the PROSPERO international prospective register of systematic reviews.

RESULTS

A total of seven studies involving 79 patients were included. At the last follow-up, the pooled proportion of patients achieving Barrow Neurological Institute (BNI) grade I was 37.5 % (95 % CI: 26.2 %-49.3 %). The proportion of patients attaining BNI grades I-IIIa was 58.5 % (95 % CI: 46.6 %-70.1 %). In terms of treatment failure, the pooled rate was 11.9 % (95 % CI: 4.6 %-21.3 %). Regarding recurrence, the pooled rate was 23.1 % (95 % CI: 13.4 %-34.0 %). The pooled complication rate was 0.2 % (95 % CI: 0.0 %-4.4 %). Among those who experienced treatment failure after microvascular decompression (MVD), 41.67 % (5/12) reached BNI grades I-IIIb, while 66.67 % (4/6) of those who failed rhizotomy achieved BNI grades I-IIIa. A total of 18 patients underwent repeat SRS; Of these, 44.4 % (8/18) achieved BNI grade I, and 66.7 % (12/18) attained BNI grades I-IIIa.

CONCLUSION

This study demonstrated that SRS is an acceptable treatment for idiopathic GPN, offering effective pain relief with an extremely low complication rate. It could serve as a valuable salvage therapy for those who have not achieved success with MVD or rhizotomy. Repeat SRS remains effective for patients experiencing recurrence.