显微手术治疗面肌痉挛合并三叉神经痛(附7例分析)

Microvascular decompression for facial spasm complicated by trigeminal neuralgia:report of 7 cases

目的探讨显微手术治疗面肌痉挛合并三叉神经痛的疗效。方法回顾性分析7例面肌痉挛合并三叉神经痛病人的手术经验。均在磁共振检查后行微血管减压治疗,观察术后疗效。结果MRI及术中均见面神经责任血管为小脑前下动脉6例,椎动脉1例;三叉神经责任血管为椎动脉4例,小脑上动脉3例。行微血管减压后,三叉神经痛症状均立即消失;面肌痉挛术后立即消失5例,术后3个月内完全消失2例。结论术前MRI检查可明确诊断并指导手术;微血管减压可有效治疗原发性面肌痉挛合并三叉神经痛。

Objective To explore the microvascular decompression for trigeminal neuralgias incorporated facial spasms. Methods Surgical experiences in 7 patients with facial spasms complicated by trigeminal neuralgias were retrospectively analyzed. All the patients were examined by MRI and were treated by microvascular decompression, and the therapeutic effects were observed. Results MRI and operations showed that the responsible vessel of the facial nerve was anterior inferior cerebellar artery in 6 cases, and vertebral artery in 1, and which of the trigeminal nerve was vertebral artery in 4 cases, and superior cerebellar artery in 3. Immediately after the microvascular decompression, trigeminal neuralgia disappeared in all the cases, and facial spasm disappeared in 5 cases with the other 2 cases relieved in 3 months after the operation. Conelusion MRI helps verify the diagnosis before operation and guide operation; microvascular decompression can efficiently cure facial spasm complicated by trigeminal neuralgia.