乙状窦后锁孔手术治疗三叉神经痛、半面痉挛和舌咽神经痛

山东大学耳鼻喉眼学报 ›› 2011, Vol. 25 ›› Issue (5): 23-.

乙状窦后锁孔手术治疗三叉神经痛、半面痉挛和舌咽神经痛

马兆鑫1，李明2，曹奕2，陈旭辉2

1．同济大学附属东方医院耳鼻喉科，上海 200120；2. 上海中医药大学附属岳阳医院耳鼻喉科，上海 200120

收稿日期:2011-07-02 修回日期:2011-08-05 出版日期:2011-10-16 发布日期:2011-10-16
作者简介:马兆鑫，同济大学附属东方医院耳鼻喉科主任，教授，主任医师，博士，博士生导师。专长：耳显微外科和耳神经外科。

Surgery by a retrosigmoid keyhole approach in treatment of trigeminalneuralgia, hemifacial spasm and glossopharyngeal neuralgia

MA Zhao-xin1, LI Ming2, CAO Yi2, CHEN Xu-hui2

Department of Otolaryngology, 1. Shanghai East Hospital, Tongji University, Shanghai 200120, China; 2. Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine, Shanghai 200120, China

Received:2011-07-02 Revised:2011-08-05 Online:2011-10-16 Published:2011-10-16

摘要/Abstract

摘要：

目的评价锁孔术治疗三叉神经痛（TN），半面痉挛（HFS）和舌咽神经痛（GPN）的疗效。方法对207例患者实施乙状窦后锁孔入路微血管减压术（MVD）和神经切断术，其中三叉神经痛169例，半面痉挛31例，舌咽神经痛7例。结果三叉神经痛治愈和好转160例（94.7％），失败9（5.3％）；半面痉挛患者症状治愈29例（93.5％），失败2例（6.5％）；舌咽神经痛患者症状治愈7例（100％）。术后未发生严重并发症，如死亡或小脑或脑干梗死等。其它并发症包括有小脑血肿1例，中度听力损失3例，暂时性面瘫3例，一侧声带不完全性麻痹1例。结论经乙状窦后锁孔入路微血管减压和神经切断术安全有效。

关键词: 乙状窦后入路；颅骨切除术；显微手术；微血管减压术；神经切断术

Abstract:

Objective The aim of the study was to describe and evaluate the efficacy of the keyhole microsurgery to manage patients with trigeminal neuralgia (TN), hemifacial spasm (HFS) and glossopharyngeal neuralgia (GPN). Methods Two hundred and seven patients underwent microvascular decompression (MVD) and neurotomy via retrosigmoid keyhole approach in our department clinic: MVD for trigeminal neuralgia 169 cases, hemifacial spasm 31 cases, glossopharyngeal neuralgia 4 cases and neurotomy for glossopharyngeal neuralgia 3 cases. There was no serious complication such as deaths or infarction in the cerebellum or the brainstem. Results Complete and partial symptoms relief was obtained in 160 (94.7%) cases and failure 9 (5.3%) cases with MVD for trigeminal neuralgia, postoperatively. Meanwhile, complications occurred in one case with cerebellar hematoma only. The postoperative results of MVD for hemifacial spasm with symptoms relief was noted in 29 (93.5%) cases and failure 2 (6.5%) cases. Postoperative complications occurred in one case with moderate hearing loss, another three cases complained of transient facial paralysis. Symptoms relief achieved in all 7 (100%) cases undergone MVD or neurotomy for glosspharyngeal neuralgia. Postoperative complications occurred in one case with moderate vocal paralysis. Conclusion We think that microsurgery via retrosigmoid keyhole approach is safe and eVective for CPA hyperactive cranial nerve dysfunction syndromes.

Key words: Retrosigmoid approach；Craniotomy；Microsurgery；Microvascular decompression；NeurotomyJannetta

中图分类号:

R745.11

马兆鑫1，李明2，曹奕2，陈旭辉2. 乙状窦后锁孔手术治疗三叉神经痛、半面痉挛和舌咽神经痛[J]. 山东大学耳鼻喉眼学报, 2011, 25(5): 23-.

MA Zhao-xin1, LI Ming2, CAO Yi2, CHEN Xu-hui2 . Surgery by a retrosigmoid keyhole approach in treatment of trigeminalneuralgia, hemifacial spasm and glossopharyngeal neuralgia[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2011, 25(5): 23-.

参考文献

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed