枕下乙状窦后锁孔经小脑桥脑裂入路治疗面肌痉挛的临床研究  

Clinical research on suboccipital retrosigmoid keyhole in treating hemifacial spasm via approach of cerebello-pontine fissure

作　　者：常书锋 杨波[2] 郑鲁 刘昌 王俊善 付战胜 杨万敬 黄晓峰 CHANG Shufeng YANG Buo ZHENG Lu LIU Cang WANG Junshan FU Zhansheng YANG Wanjin HUANG Xi- aofeng(The Third People＇s Hospital of Luoyang,Luoyang 471000, China The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052 China 150th Center Hospital of PLA,Luoyang 471031 ,China)

机构地区：[1]洛阳市第三人民医院,河南洛阳471002 [2]郑州大学第一附属医院,河南郑州450052 [3]洛阳解放军150中心医院,河南洛阳471031

出　　处：《临床医药实践》2017年第7期488-491,共4页Proceeding of Clinical Medicine

基　　金：洛阳市科技计划医疗卫生项目(项目编号:1725001A-10)

摘　　要：目的:评估枕下乙状窦后锁孔经小脑桥脑裂入路治疗面肌痉挛的安全性和有效性,探讨改良后的手术切口、骨瓣设计和打开桥脑裂上、下支的临床意义。方法:收集2009年2月—2016年1月采用该入路手术治疗的148例面肌痉挛患者的临床资料,进行回顾性分析。结果:148例均发现责任血管压迫,其中136例完全减压,12例未完全减压;术后痉挛消失134例,明显减轻14例;听力下降1例,面部轻瘫3例,脑脊漏1例。结论:该入路治疗面肌痉挛,有利于显露面神经全程,特别是面神经入脑干区,有利于责任血管的探查、减压及减轻面、听神经的牵拉,可提高治愈率、降低复发率。改良的手术切口、骨瓣符合手术要求,可减少并发症。Objective：To evaluate the safety and effectiveness of suboccipital retrosigmoid keyhole in treating hemifacial spasm via approach of cerebello - pontine fissure, explore the clinical significance of modified incision, bone flap design and o- pening ramussuperior and ramusinferior of cerebello - pontine fissure. Methods ： Clinical data of 148 Hemifacial spasm patients who accepted operation treatment via this Surgical approach from February 2009 to January 2016 were collected, then retrospec- tive analysis was performed. Results：Responsible blood vessels pressed for 148 cases, 136 cases were fully decompressed, 12 cases were not fully decompressed. After operation, prosopospasm was gone for 134 cases, prosopospasm was improved appar- ently for 14 eases;bearing loss for 1 case, mild facial paralysis for 3 cases, cerebrospinal fluid leakage for 1 case. Conclusion： During treatment of Hemifaclal spasm by this Surgical approach, the facial nerves can be exposed, especially the place where facial nerves enter brainstem, which can explore and decompress the responsible blood vessels, reduce the pulling on facial and auditory nerves, enhance cure rate and reduce relapse rate. The modified operation incision and bone flap are in conformity with operation requirements, and can reduce occurrence of complications.

关 键 词：枕下乙状窦后锁孔入路 小脑桥脑裂 微血管减压 面肌痉挛 

分 类 号：R473.6[医药卫生—护理学]