高位切断撕脱术治疗原发性三叉神经痛的临床研究(附66支/46例报告)

Transoral Approach Neurectomy at High Position for Idiopathic Trigeminal Neuralgia:A Report of 66 Branches in 46 Patients

目的探讨高位切断撕脱术治疗原发性三叉神经痛(第Ⅱ、Ⅲ支)的临床疗效。方法 46例(66支)原发性三叉神经痛患者在全身麻醉下,行口腔或健侧鼻腔插管。采用患侧口腔前庭及翼下颌韧带外侧切口,行上颌神经、下牙槽神经、颊长神经、舌神经高位切断撕脱术。结果术后控痛率达100%,术后随访4个月～5年,治愈30例,占65%;好转11例,占24%;无效而改用其他治疗5例,占11%。总有效率达89%。结论三叉神经高位切断撕脱术治疗原发性三叉神经痛安全、创伤小、临床治愈率高。

Objective To explore the clinical effect of transoral approach neurectomy at high position on idiopathic trigeminal neuralgia （the second branch and the third branch）. Methods 66 branches in 46 patients idiopathic trigeminal neuralgia, oral or contralateral nasal intubation and incisions in ipsilateral buccal cavity and lateral to pterygomandibular ligament were performed in patients with idiopathic trigeminal neuralgia. Then the surgical resection of maxillary nerve,inferior alveolar nerve,buccal nerve and ingual nerve at high position were carried out under general anesthesia. Results The pain control rate was 100%. After 4 to 60 months of follow-up,complete relief was achieved in 30 patients（65%） and partial relief in 11（24%）. Five patients （11%） did not achieved the relief and received other treatments. The total effective rate was 89 %. Conclusion Transoral approach neurectomy at high position is a safe, effective and minimally invasive surgery for idiopathic trigeminal neuralgia.