乳突后横切口锁孔入路在颅神经疾病患者微血管减压术中的应用探讨  

Clinical application of post mastoid transverse incision in keyhole microvascular decompression

作　　者：丁晓东[1] 刘霞[1] 陈兵[1] 窦以河[1] Ding Xiaodong;Liu Xia;Chen Bing;Dou Yihe(Department of Neurosurgery,Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院神经外科,青岛266000

出　　处：《中华神经医学杂志》2018年第9期949-952,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨乳突后横切口锁孔入路在颅神经疾病患者微血管减压术中的临床应用价值。方法回顾性分析青岛大学附属医院西海岸院区神经外科自2015年10月至2017年10月收治的采用乳突后横切口锁孔入路行微血管减压术治疗的58例三叉神经痛、面肌痉挛、舌咽神经痛患者的临床资料及疗效。结果58例患者的病患颅神经均显露满意，术后并发面部重度麻木1例、皮下积液1例、耳部不适2例、听力减退2例，无感染、脑脊液漏者，无面瘫或听力丧失者，无声音嘶哑或饮水呛咳者，无颅内出血或死亡者。术后随访3～24个月，总有效率为98．3％（57／58）。无复发或加重者。结论乳突后横切口锁孔入路在微血管减压术治疗颅神经疾病中具有开关颅方法简单、入路简捷、神经显露充分、手术安全性高、术后美容效果良好等优势，值得临床推广应用。Objective To explore the clinical value of post mastoid transverse incision in keyhole microvascular decompression （MVD） for cranial neuropathy. Methods Fifty-eight patients with trigeminal neuralgia, hemifacial spasm or glossopharyngeal neuralgia, admitted to and accepted postmastoid transverse incision keyhole surgery in our hospital from October 2015 to October 2017, were chosen. Their clinical data and efficacy were retrospectively analyzed. Results Lesions of cranial nerves in all 58 patients were exposed satisfactorily （trigeminal nerve, facial nerve, or glossopharyngeal nerve）. Postoperative complications included severe facial numbness in one patient, scalp hydrops in one patient, ear discomfort in two patients, and hearing loss in two patients. No cerebrospinal fluid leakage or intracranial infection, no facial paralysis or ear deafness, no hoarseness or drinking cough, and no intracranial hemorrhage or death were observed. All patients were followed up for 3-24 months, enjoying total effective rate of 98.3% （57/58）; and no recurrence or aggravation was noted. Conclusion MVD of post mastoid transverse incision in keyhole is a safe and effective surgical method for treatment of cranial nerve disorders; the steps of craniotomy and craniotomy in this method are simple, easy accessed, and fully neurologically exposed, having high surgical safety and good postoperative cosmetic results, which is worth of promoting application.

关 键 词：乳突后入路 横切口 锁孔手术 微血管减压术 颅神经疾病 

分 类 号：R745.1[医药卫生—神经病学与精神病学]