CT引导下颈侧入路射频热凝合并无水乙醇毁损术治疗舌咽神经痛

CT-guided radiofrequency neurolysis combined with ethanol ablation at neck side for the treatment of glossopharyngeal neuralgia

目的探讨CT引导下颈侧入路舌咽神经射频热凝合并无水乙醇毁损术对舌咽神经痛的疗效。方法对35例舌咽神经痛患者在CT引导下采用颈侧入路经皮穿刺,进行舌咽神经射频热凝合并无水乙醇毁损术,观察术前、术后1周及出院随访时的疼痛情况、情绪评分以及并发症。结果 28例患者术后疼痛消失,4例术后疼痛减轻,余3例合并三叉神经痛患者术后接受半月神经节射频毁损术,术后疼痛消失。随访期间30例疼痛消失无复发,2例在出院1个月内疼痛消失,1例部分缓解,2例患者术后6个月复发。所有患者视觉模拟评分疼痛与情绪评分明显降低,无严重并发症发生。结论 CT引导下颈侧入路射频热凝合并无水乙醇毁损术治疗舌咽神经痛安全、疗效可靠,定位准确,可有效降低严重并发症的发生率。

Objective To observe the value of CT-guided radiofrequency neurolysis combined with ethanol ablation at neck side for the treatment of glossopharyngeal neuralgia.Methods Thirty-five patients of glossopharyngeal neuralgia（GPN）underwent CT-guided radiofrequency neurolysis combined with ethanol ablation at neck side.The state of pain,emotional scale and complication were evaluated before operation,1 week after operation and during follow-up.Results After operation,pain disappeared in 28 patients,eased in 4 patients.The pain of other 3 patients released after percutaneous radiofrequency thermocoagulation for trigeminal neuralgia.During follow-up,GPN disappeared and not recurred in 30 patients,pain released 1 month later in 2 patients,while partial remission was noticed in 1 patient,and secondary neuralgia recurrence in 2 patients after 6 months.Visual analogue scale,state of pain,emotional scale decreased,and no serious complication was observed.Conclusion CT-guided radiofrequency neurolysis combined with ethanol ablation at neck side is safe and effective for the treatment of GPN.