神经内镜技术在桥小脑角区部分脑神经疾病中的临床应用  

Clinical application of neuroendoscopy for some cranial nerve diseases in cerebellopontine angle area

作　　者：唐寒 黄国栋[2] 那鹏 徐湘平 潘昱辰 张协军[2] 阳吉虎 李维平[2] Tang Han;Huang Guodong;Na Peng;Xu Xiangping;Pan Yuchen;Zhang Xiejun;Yang Jihu;Li Weiping(University of South China,Hengyang,Hunan 421001,China;Department of Neurosurgery,Shenzhen Second People's Hospital/Shenzhen Key Laboratory of Neurosurgery,Shenzhen,Guangdong 518035,China)

机构地区：[1]南华大学,衡阳421001 [2]深圳市第二人民医院神经外科深圳市神经外科重点实验室,518035

出　　处：《中国微侵袭神经外科杂志》2020年第12期539-542,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：南华大学研究生科研创新项目资助(编号:203YXC038)。

摘　　要：目的探讨神经内镜技术在桥小脑角区(cerebellopontine angle area,CPA)脑神经疾病中的临床应用。方法回顾性分析57例CPA区脑神经疾病病例资料,采用全神经内镜技术或神经内镜联合显微镜技术,明确责任血管或责任灶来源。结果术后随访6~36个月。25例原发性面肌痉挛症状完全缓解,3例Cohen和Albert分级由术前Ⅲ级转变为Ⅰ级。19例原发性三叉神经痛症状完全缓解,2例疼痛BRS分级由术前Ⅴ级转变为Ⅱ级。6例CPA区继发性三叉神经痛症状基本缓解,2例症状明显减轻。本组病例无继发性面瘫及听力损伤,无脑脊液漏,无复发及死亡。结论神经内镜技术在治疗CPA区脑神经疾病中,能清晰无死角显示术区解剖结构,有利于发现责任病灶及直观观察减压后效果,术后随访疗效确切,无严重并发症。Objective To explore the clinical efficacy of neuroendoscopy for cranial nerve diseases in cerebellopontine angle area(CPA). Methods The data of 57 patients with cranial nerve diseases in the CPA, using complete neuroendoscopy or neuroendoscopy combined with microscopy for identify the responsible blood vessel or the source of the responsible focus, were analyzed retrospectively.Results The follow-up period was 6 to 36 months. The symptoms of 25 cases of primary hemifacial spasm were completely relieved,and the Cohen and Albert grades of 3 cases changed from grade Ⅲ to grade Ⅰ. The symptoms of 19 cases of primary trigeminal neuralgia were completely relieved, and the BRS grade of pain in 2 cases changed from grade V to grade Ⅱ. The symptoms of secondary trigeminal neuralgia in the CPA were basically relieved in 6 cases, significantly relieved in 2. This group of cases had no secondary facial paralysis and hearing impairment, no cerebrospinal fluid leakage, no recurrence or death. Conclusions In the treatment of cranial nerve diseases in the CPA, neuroendoscopic technique can clearly show the anatomical structure of the operation area without omission,which is beneficial to find the responsible lesion and visually observe the effect of decompression. The postoperative follow-up effect is definite without serious complications.

关 键 词：神经内镜 桥小脑角区 脑神经疾病 

分 类 号：R745.1[医药卫生—神经病学与精神病学]