桥小脑角区显微手术治疗三叉神经痛101例

Microsurgical treatment of trigeminal neuralgia in cerebellopontine angle

目的 介绍１０１ 例三叉神经痛经桥小脑角显微手术治疗经验。方法 分析１０１ 例三叉神经痛的病因、术式选择及复发率，并就减少并发症进行探讨。结果 ３ 例胆质瘤切除术后三叉神经痛症状均消失。余９８ 例术后疼痛即刻消失者８８ 例；１０ 例仍疼痛但程度减轻，均存在于６２ 例行微血管减压术式者中，其中５ 例于术后１０ ｄ 内疼痛消失，另５ 例口服药物可控制。近期有效率１００ ％ ，近期治愈率８９８ ％ 。无死亡病例。共随访成功６５ 例，随访时间０５ ～７ ａ ，复发６例。结论 治疗三叉神经痛的桥小脑角区显微是最接近其病因的治疗，并视术中情况进一步实施微血管减压术或感觉根部分切断术，是治疗三叉神经痛较理想的手术。

Objective To introduce the microsurgical experience in treatrnent of trigeminal neuraglia in cerebellopontine angle of101 cases . Methods Etiology ,operative methods and recurrence rate ofthe disense are analyzed . The way to decrease complications isalso discussed . Results Ofthese 101 patients ,3 with cholesteatoma removaed sugically had no recurrence of pain ,88 obtained im medi ate virtually complete relief ofthe trigeminal neuralgia postoperatively ,and 10 ,who part ofthe 62 receiving microvascular decompression,stiu had pain butless severe than preoperatively . In the latter,5 had no recurrence of pain within 10 days ,5 had pain well controlledwith carbamazepine . The early effective rate was 100 % ,and the early postoperative cure rate was 89 .8 % ,withoutfatalitg . There were 6with recurrence of pain in 65 who were followed up for 0 .5 to 7 years . Conclusion The microsurgery in cerebellopontine angleisthera peutic procedure in based on in etiology . In the light of concrete conditions ofthe procedure the microvascular decompression of partialsensory rhizotomy wasfurther performed on a patient. Microsurgicaltreatmentfortrigeminal neuragliain the cerebellopontine angle isrec ommended as a satisfactory procedure(operative) for patients with trigeminal neuralgia who are surgical candidates .