显微血管减压术治疗舌咽神经痛20例  

Microvascular Decompression for 20 Cases of Glossopharyngeal Neuralgia

作　　者：王小强[1] 尹文杰 田川 韩彦明[1] 李强[1] 张新定[1] Wang Xiaoqiang;Yin Wenjie;Tian Chuan(Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou 730030, China)

机构地区：[1]兰州大学第二医院神经外科,兰州730030

出　　处：《中国微创外科杂志》2022年第5期403-406,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：兰州大学第二医院萃英创新计划(CY2020-BJ02)。

摘　　要：目的探讨显微血管减压术(microvascular decompression,MVD)治疗舌咽神经痛的疗效。方法回顾性分析2010年1月~2019年12月20例原发性舌咽神经痛资料,均采用乙状窦后小骨窗行MVD,特氟隆垫片解除神经血管接触,均未行神经根切断。随访1年以上。结果责任血管为小脑后下动脉18例,小脑后下动脉和椎动脉2例。舌咽神经受压部位为神经根进出脑干区(root entr/exit zoon,REZ)16例,REZ区和远端3例,远端1例。3例合并三叉神经痛,均同时行三叉神经和舌咽神经减压术。术中暂时性血流动力学不稳定1例,无严重术中、术后并发症,无死亡。随访13~90个月,平均38.5月。19例术后立即无症状,均无复发,1例偶尔有不需要药物治疗的疼痛。结论未行神经根切断的MVD治疗舌咽神经痛安全有效。Objective To evaluate the curative effect of microvascular decompression(MVD)for glossopharyngeal neuralgia.Methods A retrospective analysis was made on 20 patients with primary glossopharyngeal neuralgia from January 2010 to December 2019.All the patients underwent microvascular decompression through the small bone window behind the sigmoid sinus.The Teflon was used to relieve the neurovascular compression during the operation,and the nerve rhizotomy was not performed.All the patients were followed up for more than 1 year.Results Among the 20 patients,the responsible vessels were posterior inferior cerebellar artery in 18 cases,and vertebral artery combined with posterior inferior cerebellar artery in 2 cases.The compression sites of glossopharyngeal nerve were root entr/exit zoon(REZ)area in 16 cases,REZ area and distal in 3 cases,and distal in 1 case,respectively.There were 3 patients combined with trigeminal neuralgia,who underwent decompression for trigeminal nerve and glossopharyngeal nerve at the same time.There was 1 case of transient hemodynamic instability during operation.No serious intraoperative or postoperative complications were found.No death happened.The patients were followed up for 13-90 months,with an average of 38.5 months.A total of 19 patients were asymptomatic immediately after operation,without recurrence.One patient occasionally had pain that did not need drug treatment.Conclusion Microvascular decompression without nerve rhizotomy is a safe and effective method for glossopharyngeal neuralgia.

关 键 词：舌咽神经痛 显微血管减压术 

分 类 号：R73[医药卫生—肿瘤]