舌咽神经痛的病因与显微手术治疗(附9例临床分析)

The pathogeny and microsurgery treatment of glossopharyngeal neuralgia(a report of 9 cases)

目的探讨舌咽神经痛的发病原因和神经根切断术治疗效果。方法对9例舌咽神经痛患者，经乙状窦后进路行桥小脑角探查并舌咽神经切断术。结果9例患者中，6例术中探查发现有4例小脑上动脉压迫，2例神经根部蛛网膜增厚粘连者只行舌咽神经切断术。3例术中探查未见责任血管压迫和蛛网膜者增厚粘连，行舌咽神经根及迷走神经根上部1～2根丝切断术。术后疼痛症状均消失。结论舌咽神经血管压迫和蛛网膜增厚粘连可能是舌咽神经痛的发病原因．但不是唯一原因；舌咽神经根切断术疗效肯定。

Objective To investigate the etiopathogenesis of glossopharyngeal neuralgia, and to research the curative effect of rhizotomy. Methods Nine patients with glossopharyngeal neuralgia were treated by operation in which the glossopharyngeal nerves were explored and sectioned. Results 4 of 9 patients were explored that their glossopharyngeal nerve were compressed by the posterior inferior cerebellar arteries. 2 of 9 patients were adhered by thickening arachnoid, they were treated by glossopharyngeal neuralgia rhizotomy, and 3 of 9 patients were neither, They were severed 1-2 branch superior part of pneumogastric nerve on the basis of glossopharyngeal nerves rhizotomy. 9 patients algesic symptom disappear after operation. Conclusion Vascular compression and arachnoid adhesion may be the causes of glossopharyngeal neuralgia, but not the only one. The curative effect of section of glossopharyngeal nerve is sure.