舌咽神经痛的显微外科手术治疗(附17例病例分析)

MICROSURGICAL TREATMENT OF GLOSSOPHARYNGEAL NEURALGIA (A REPORT OF 17 PATIENTS)

目的：探讨治疗舌咽神经痛的有效手术方法。方法：１９８６年１月～１９９７年１２月，对１７例舌咽神经痛患者进行了外科手术治疗，其中显微血管减压术３例、血管减压术同时行舌咽神经根及迷走神经上部１根～２根丝切断术４例、舌咽神经根及迷走神经上部１根～２根丝切断术１０例。结果：１７例患者疼痛全部消失，３例出现偶发性干咳，其中１例伴轻度声音嘶哑及吞咽功能障碍。结论：显微血管减压术、舌咽神经根及迷走神经上部１根～２根丝切断术或２种术式合用均为治疗舌咽神经痛的有效治疗方法。

Objective:To explore effective surgical methods for the treatment of glossopharyngeal neuralgia.Methods:Between 1986 to 1997,17 patients with glossopharyngeal neuralgia were treated by using microsurgical techniques in our department.Of them three patients underwent microvascular decompression(MVD),four received MVD combined with rhizotomy of glossopharyngeal nerve root and upper 1st to 2nd rootlets of vagus nerve root,10 cases were treated by rhizotomy of glossopharyngeal nerve root and upper 1st to 2nd rootlets of vagus nerve.Results:The neuralgia was disappeared in all cases postoperatively.In three cases occasional coughing episodes occurred postoperatively,of which one patient was also complicated with mild hoarseness and swallowing difficulty.Conclusion:MVD,rhizotomy of glossopharyngeal nerve root and upper 1st to 2nd rootlets of vagus nerve and combination of former two methods are effective surgical methods for the treatment of glossophryngeal neuralgia.The choice of operative methods should be based upon compression of nerve roots by affected vessels or not and the severity of compression.