CPA表皮样囊肿继发三叉神经痛的临床特点及危险因素分析  

Clinical characteristics and risk factors of trigeminal neuralgia secondary to CPA epidermoid cyst

作　　者：刘霄[1] 李锴[1] 郭亚洲[1] 王常伟[1] 刘禹 张晓阳[1] 刘德中[1] LIU Xiao;LI Kai;GUO Yazhou;WANG Changwei;LIU Yu;ZHANG Xiaoyang;LIU Dezhong(Department of Neurosurgery,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院神经外科,河南周口466000

出　　处：《中国实用神经疾病杂志》2018年第21期2388-2393,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨由CPA表皮样囊肿导致的继发性三叉神经痛的临床特点与手术疗效,以及其与原发性三叉神经痛的差别。方法回顾分析周口市中心医院2015-01—2018-07 12例由CPA表皮样囊肿导致的继发性三叉神经痛的临床资料,同时分析224例特发性三叉神经痛的临床资料。均经乙状窦后入路显微手术切除肿瘤。结果单因素分析显示继发于表皮样囊肿的三叉神经痛患者年龄均较轻,年龄(46.3±8.5)岁,同时继发性三叉神经痛的病程通常较短。肿瘤全切10例,次全切除2例。10例疼痛症状消失,2例术后3个月疼痛症状消失,随访3个月～3a疼痛无复发。术后住院期间发生短期患侧面部麻木1例,面部感觉减退5例,面瘫4例(House-BrackmannⅡ-Ⅲ级),听力下降1例,随访3个月后症状均恢复,所有患者术后无死亡及重残。结论 CPA表皮样囊肿继发三叉神经痛多数由于CPA区占位直接或间接压迫神经所导致,早期病变小,症状发作年龄较小,症状持续时间短,多数易于切除,手术疗效满意。Objective CPA epidermoid cyst combined with trigeminal neuralgia is rare.This study was to investigate the clinical features and surgical outcomes of secondary trigeminal neuralgia caused by CPA epidermoid cyst,and to explore the difference between the secondary trigeminal neuralgia and primary trigeminal neuralgia.Methods A retrospective analysis was made in our hospital from January 2015 to July 2018.The clinical data of 12 secondary trigeminal neuralgia caused by CPA epidermoid cysts and 224 cases of primary trigeminal neuralgia were analyzed.All the tumors were removed by retrosigmoid approach.Results Univariate analysis showed that patients with trigeminal neuralgia secondary to epidermoid cysts were younger,about(46.3±8.5)years old,and the duration of secondary trigeminal neuralgia was usually shorter.There were 10 cases of total tumor resection and 2 cases of subtotal resection.10 cases of pain disappeared,and the pain symptoms disappeared in 2 cases after 3 months.There was no recurrence after 3 months to 3 years of follow up.One case of short term side numbness occurred in 5 cases of postoperative hospitalization,5 cases of facial sensation decreased,4 cases of facial paralysis(House-BrackmannⅡ-Ⅲ),1 case of hearing loss,symptoms recovered after 3 months of follow-up,all patients had no postoperative Death and severe disability.Conclusion The trigeminal neuralgia secondary to the epidermoid cysts of CPA were mostly caused by direct or indirect compression of nerves in CPA.The early lesions were small,the onset of symptoms was younger and the duration of symptoms was short,most of them were easy to resect,and the results of operation were satisfactory.

关 键 词：继发性三叉神经痛 桥小脑角区占位 表皮样囊肿 微血管减压术 

分 类 号：R745.11[医药卫生—神经病学与精神病学]