摘要
目的探讨经小脑水平裂-小脑桥脑裂入路治疗三叉神经痛的经验教训。方法回顾性分析经小脑水平裂-小脑桥脑裂入路治疗的连续133例三叉神经痛病例。结果所有患者均可顺利或较顺利的分开小脑水平裂外侧部和小脑桥脑裂上支,岩静脉均得到妥善处理,128例有明确责任血管压迫,5例可疑血管压迫,均行个体化围套式减压,术后立即止痛129例,术后3～5天止痛3例,1例疼痛减轻约50%。无死亡,1例听力下降,1例面部轻瘫,11例出现口唇疱疹,8例患侧面部轻微麻木。1例(0.75%)术后10个月复发。结论经小脑水平裂——小脑桥脑裂入路治疗三叉神经痛,可以避免传统的枕下乙状窦后入路三叉神经感觉根入桥脑处显露不良的缺陷,提高有效率,减少听力下降、面瘫等并发症的发生。
Objective To summarize the experience and lessons learned from the patients treated via the approach of transhorizontal-cerebellopontine fissure for microvascular decompression （MVD） of trigeminal neuralgia （TN）. Methods A retrospetive analysis of the data of 133 consecutive patients with TIN via transhorizontal-cerebellopontine fissure approach for MVD of TiN was performed. Results The dissection of the cerebellar horizontal-cerebellopontine fissure of the 133 cases was performed successfully and the superior petrosal vein was disposed properly. Offending vessels were found in 128 cases and suspicious offending vessels in 5 cases. Microvascular decompression with an encircling method was performed individually depending on each patient. Postoperatively, 129 cases were pain free immediately, three cases pain free 3-5 days afterwards, and one case subsided about 50%. Decreased hearing was found in one case, and facial paresis in one case. 11 cases developed herpes labialis and 8 cases slightly facial numbness. Pain recurred in one case 10 months postoperatively. Conclusion The transhorizontal -cerebellopontine fissure approach for MVD of TN could avoid the defects of the standard suboccipital retrosigmoidal approach, which allowes easy identification of the root exit zone of the trigeminal nerve and the offending vessel（s） and minimal retraction of the facial nerve and the vestibulocochlear nerve that greatly reduced the complication rate of hearing disturbance and facial paralysis, and good results could be expected.
出处
《立体定向和功能性神经外科杂志》
2012年第4期216-218,共3页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
手术入路
小脑水平裂
小脑桥脑裂
三叉神经痛
微血管减压术
Approach
Horizontal fissure
Cerebellopontine fissure
Microvascular decompression
Trigerninal neuralgia
