三叉神经痛与颌骨骨腔病变:45例分析(英文)

Trigeminal neuralgia and jaw bone cavities: analysis of 45 cases

背景:三叉神经痛的发病原因中因牙源性感染因素所致,在继发三叉神经痛的病因学研究中愈来愈受到重视,并提出了颌骨骨腔病变学说。目的:研究颌骨病变性骨腔与三叉神经痛病因的关系。设计:以患者为研究对象,前后对照研究。单位:一所大学医院口腔颌面外科。对象:1994-02/2003-12青岛大学医学院附属医院口腔颌面外科收治的三叉神经痛患者45例,其中男15例,女30例,共发现病变性骨腔74个。方法:45例均行颌骨病变性骨腔清除术,术后应用视觉模拟评分法(VAS)对患者的疼痛程度进行评估。主要观察指标:①VAS评分。②手术刮出物病理学检查和细菌培养。结果:1次手术后疼痛消失者33例,占73.3%,两三次手术后疼痛消失者10例,占22.2%。疼痛缓解仍需要药物治疗维持2例,占4.5%。病理检查结果多为颌骨慢性炎症及肉芽组织。结论:颌骨病变性骨腔是引起三叉神经痛的主要病因之一。

BACKGROUND:Odontogenic infection factor has been given much importance in the study of the etiology of secondary trigeminal neuralgia,and the theory of jaw bone cavities is proposed. OBJECTIVE:To study the relationship of the jaw bone cavities and the etiology of trigeminal neuralgia. DESIGN:A selfa2 controlled trial.SETTING:Department of oral and maxillofacial surgery of a university hospital.PARTICIPANTS:The patients with the trigeminal neuralgia were treated in Department of Oral and Maxillofacial Surgery,Affiliated Hospital of the Medical College of Qingdao University from February 1994 to December 2003,from whom 45 were selected for this study, including 15 males and 30 females with altogether 74 jaw bone cavities. METHODS:Curettage of the jaw bone cavities was performed in these cases,and visual analogue scale(VAS) was adopted for evaluation of the postoperative pain.MAIN OUTCOME MEASURES:￠ù VAS;￠ú Pathological examination and bacteria culture of the specimens.RESULTS:Pain relief was achieved in 33 cases(73.3￡$ ) after the first surgery and in 10 cases(22.2￡$ ) after a second or third surgery.In 2 cases (4.5￡$ ),the pain was alleviated but medication was still needed for pain control.Pathological examinations in most cases identified predominantly inflammatory and granulation tissues.CONCLUSION:Jaw bone cavities may be one of the major etiologic factors of trigeminal neuragia.