摘要
目的探讨乙状窦后锁孔入路显微血管减压术治疗面肌痉挛的手术方法、效果及并发症。方法回顾性分析120例乙状窦后锁孔入路显微血管减压术患l者的临床资料、手术资料和随访结果。术前常规行CT、MRI检查排除继发性病因。术中采用乙状窦后锁孔入路，缓慢释放脑脊液，牵开小脑，探查面神经出脑干区，确认异常压迫血管，将其推离此区，并用适当大小的Teflon棉团絮状放置在责任血管和脑干之间，使责任血管远离面神经根部。结果全部病例术中均发现有明确的压迫血管，主要为小脑前下动脉和后下动脉，其中小脑前下动脉54例（45．3％），小脑后下动脉41例（34．8％）。全部病例随访0．5～8年，无复发病例，总有效率为97．5％。结论乙状窦后锁孔入路显微血管减压术是治疗面肌痉挛的有效治疗方法，应作为临床治疗面肌痉挛的首选。
Objective To investigate the operation method, effect and complications of micro- surgical vascular decompression by sigmoid sinus posterior keyhole approach in treatment of hemifacial spasm. Methods The clinical data, operation data and follow-up results of 120 patients with microsurgical vascular decompression by sigmoid sinus posterior keyhole approach were retrospectively analyzed. CT, MRI examination was performed preoperatively to exclude secondary etiology. Sigmoid sinus posterior keyhole was used intraoperatively, the cerebrospinal fluid was released slowly, the cerebellum pulled, the facial nerve REZ was explorated, the anomalous vascular compression was confirmed and pushed away from the area, and the proper size of Teflon batt was placed between the responsible vessels and brain stem, to make the responsible vessels away from the facial nerve root. Results Clear pressure vessels were found in all eases, mainly were the anterior inferior eerebellar artery and posterior inferior artery,including 54 cases （45. 3%） of anterior inferior cerebellar artery, 41 cases （34.8%）of posterior inferior cerebellar artery. All patients were followed up for 0.5 to 8 years, no recurrence cases, and the total effective rate was 97.5%. Conclusions Microsurgical vascular decompression by sigmoid sinus posterior keyhole approach is the effective method for treating hemifacial spasm, should be the preferred method for clinical treatment of HFS.
出处
《中国实用医刊》
2012年第24期36-38,共3页
Chinese Journal of Practical Medicine
关键词
面肌痉挛
显微外科
血管减压
锁孔
Hemifacial spasm
Microsurgery
Vascular decompression
Keyhole
