颅后窝锁孔入路微血管减压术治疗原发性三叉神经痛

Microsurgical treatment of spinal cord hemangioblastoma

目的总结锁孔入路治疗原发性三叉神经痛的手术技巧及治疗效果。方法采用锁孔入路微血管减压术治疗原发性三叉神经痛128例,其中三叉神经根入脑干区有明显血管压迫123例,难以明确责任血管5例。结果术后随访6～ 48个月,平均32个月。治愈102例,显效16例,有效8例,无效2例。复发4例,经再次行微血管减压术治愈2例。术后出现周围性面瘫3例,同侧听力下降1例,经对症治疗痊愈,无颅内感染及死亡病例。结论三叉神经微血管减压术可作为治疗原发性三叉神经痛的首选外科方法。

Objective To explore microsurgical techniques in the treatment of spinal cord hemangioblastoma.Methods The clinical data of 16 patients with spinal cord hemangioblastoma were analyzed retrospectively.The preoperative angiography was performed in all the patients,9 of whom underwent complete or partial embolization.The intraoperative indocyanine green angiography was used to confirm the associated vessels again and the tumors were removed by microsurgery.Results Total tumor removal was achieved in all the patients.Spinal cord function was evaluated by McCormick grade： improvement was found in 12 patients,no change in 3 and worsening in 1 after 3 months of follow-up period.Conclusions Microsurgery of spinal cord hemangioblastoma can achieve good results.Preoperative angiographic embolization and intraoperative fluorescence angiography are helpful to reduce intraoperative bleeding and improve surgical safety.