面肌痉挛责任血管压迫面神经根的解剖特点

Microanatomic study on the facial nerve and their adjacent vessels in idiopathic hemifacial spasm

目的探讨特发性面肌痉挛(idiopathic hemi facial spasm,IHFS)的面神经根部责任血管的临床解剖特点。方法选择IHFS 160例,在神经根血管减压术中采用显微镜或鼻内镜观察面神经根周围病变。结果可见责任血管154例(96.2%),依次为小脑前下动脉、小脑后下动脉、小脑上动脉、椎动脉以及两支血管压迫。压迫部位在面神经根入脑桥处151例(98%),且多居前方,同时伴蛛网膜粘连(107/154,69.5%)。未见血管压迫及占位病变者6例(3.8%)。结论 IHFS责任血管多为一支,也可为两支;压迫部位在面神经根入脑桥处前方,位置隐蔽。因此,神经根血管减压术(micro vascular decompression,MVD)术中应该仔细寻找,以免遗漏责任血管。

OBJECTIVE To study the microanatomic relationship between the facial nerve and their adjacent vessel in patients with idiopathic hemifacial spasm（IHFS）.METHODS 160 cases of IHFS were included in this group.The microanatomic relationship between the facial nerve and their adjacent vessel at the root exit zone in 154（96.2%）cases,which were anterior inferior cerebella artery（AICA）,posterior inferior cerebella artery（PICA）,superior cerebella artery（SCA） and vertebral artery（VA）.There were no offending vessels（REZ）of facial nerve were observed under microscope or nasoendoscope during microvascular decompression（MVD）.RESULTS The offending vessels were found in 6 cases.The compressing site was mostly in front of the root exit zone（REZ）of facial nerve.The associated with arachnoids adhesion was found in 107（69.5%） cases.CONCLUSION The offending vessel may be one or two.The compressing site is in front of REZ and is very convert.Attention must be paid to identify the Pathological Conditions,Anatomical;offending vesselcompressing vessels in MVD.