微血管减压术治疗原发性三叉神经痛

Microvascular decompression for primary trigeminai neuralgia

目的综合评价三叉神经微血管减压术治疗原发性三叉神经痛的近远期疗效及手术风险。方法回顾性分析三叉神经微血管减压术治疗的原发性三叉神经痛25例患者临床资料。手术采用乙状窦后入路,术中分离血管神经后用Teflon补片分隔。结果术中发现24例有血管压迫,18例为小脑上动脉压迫,1例为基底动脉,3例为小脑前下动脉,1例为岩静脉压迫,1例为小脑上动脉和岩静脉压迫,另1例未发现血管压迫。结论三叉神经显微血管减压术临床适应证广泛,对神经损伤小,临床疗效满意,但手术风险不容忽视。

Objective To evaluate the effect and safety of mierovaseular decompression ＂（MVD） in the management of primary trigeminal neuralgia（TN）. Methods The clinical data of 25 patients with unilateral primary TN by microvascular decompression were analyzed retrospectively. The operation was accessed through retrosigmoidal approach and the nerve root was separated away from pressure vessels by Teflon. Results Trigeminal nerves were pressed by blood vessels in 24 cases including superior cerebellar artery in 18, basilar artery in 1, anterior inferior cerebellar artery in 3, petrosal vein in 1, superior cerebellar artery and petrosal vein in 1 and no artery or vein in 1. Conclusion The proposed surgical strategy of standard MVD was a good strategy option for TN, but it was important for surgeons to pay attention to the risks of the surgery.