经颅舌咽神经切断术治疗原发性舌咽神经痛

Transcranial neurotomy cure primary glossopharyngeal neuralgia

研究原发性舌咽神经痛的诊断、手术治疗及预防。方法：采用术前术中双重诊断法、改良经颅 舌咽神经切断术、舌咽神经剪进行诊断治疗。对该病做流行病学调查。结果：前１０例用传统术式与后２０例用改 良术式加舌咽神经剪相比较，后者住院日短、并发症少，操作简便。单纯切断舌咽神经者１７例，同时切断迷走神 经根丝者１３例，后者常遗留永久性神经损害症状。有明确上咽部及面颅慢性炎症者１９例，占６３％。结论：①改 良经颅舌咽神经切断术加舌咽神经剪是治疗原发性舌咽神经痛最简便、安全、可靠的方法。②双重诊断法不但使 诊断确立无误，也决定是否切断迷走神经根丝。而迷走神经损害较严重，应尽量避免。③上咽部及面颅慢性炎症 至少是主要诱因，应预防治。

To study the diagnosis, Operation and prevention of 30 cases primary glossopharyngeal neuralgia. Methods: Double diagnosis, the improved craniotomy and glossopharyngeal nerve scissors. Ressults: In 17 of the 30 cases transcranial neurotomy of the 9th nerve alone were performed(Another 13 cases transcndal neurotomy of the 9th nerve as swell as the uppest two rootlets of the 10th nerve were performed, but left permanent nerve deficit. The use of improved craniotomy and glossopharyngeal nerve scissors is better more than traditional neurotomy. Conclusion:①The improved transcranial neurotomy with ylossopharyngeal nerve scissors is the best method of curing primary glossopharynageal neuralgia. ②The double diagnosis is clear and avoids mis-neurotomy of the 10th nerve. ③Upper pharygeal and facial cranial chronic inflammation is the main re mote cause.