单侧咀嚼肌痉挛的显微手术治疗(附7例报道)  

Curative effect of different surgical methods on unilateral masticatory muscle spasm(report of 7 cases)

作　　者：武广永 张志宇 刘志 周景儒[1] 王栋梁[1] 焦风[1] 刘如恩[1] WU Guang-yong;ZHANG Zhi-yu;LIU Zhi;ZHOU Jing-ru;WANG Dong-liang;JIAO Feng;LIU Ru-en(Department of Neurosurgery, People's Hospital, Peking University, Beijing 100044, China)

机构地区：[1]北京大学人民医院神经外科,北京100044

出　　处：《中国临床神经外科杂志》2017年第12期808-810,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨单侧咀嚼肌痉挛的显微手术方法及其疗效。方法回顾性分析2010年3月至2016年9月显微手术治疗的7例单侧咀嚼肌痉挛的临床资料;均行三叉神经运动支显微血管减压术,其中3例同时行三叉神经运动支完全切断术,4例同时行三叉神经运动支部分切断术。术后随访5~87个月。结果术中发现3例责任血管为小脑上动脉,2例为岩静脉,1例为小脑上动脉和岩静脉,1例无明显责任血管。运动支完全切断的3例中,2例术后症状消失;1例术后症状减轻,3个月后消失;3例随访期间无复发,其中1例颞肌轻度萎缩,未影响面容,未出现张口受限。三叉神经痛运动支部分切断4例中,1例术后症状消失,随访无复发;1例术后症状减轻,随访期间未消失;2例术后症状消失,术后2年症状复发。结论三叉神经运动支部分切断对不能收到满意疗效。三叉神经运动支完全切断可达到治愈的疗效,部分病人可能会术侧轻度颞肌萎缩。Objective To observe the effects of different surgical treatments on unilateral masticatory muscle spasm(UMMS).Methods The clinical data of7patients with UMMS,of whom,3underwent microvascular decompression(MVD)and complete amputation of the trigeminal motor branches(TMB)and4MVD and amputation of the partial TMB from March,2010to September,2016,were analyzed retrospectively.All the patients were followed-up by outpatient and telephone interview after the surgery.Results The postoperative symptoms disappeared in3undergoing the complete amputation of TMB1patient had mild atrophy of temporal muscle and2not during the following-up.Of4patients undergoing amputation of the partial TMB,3had no UMMS again and1mild UMMS immediately after the operation.Of3patients with disappearance of the symptoms after MVD and amputation of partial TMB,2suffered from the UMMS again and1did not during the following-up.Conclusions The effect of MVD and partial amputation of TMB on the UMMS was not satisfactory.Complete amputation of TMB can achieve satisfactory outcomes but may lead to mild temporal muscle atrophy in the patients with UMMS.

关 键 词：单侧咀嚼肌痉挛 显微血管减压术 三叉神经运动支切断术 疗效 

分 类 号：R745.11[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]