显微血管减压术治疗眩晕、耳鸣疗效分析

Therapeutic effects of vestibulocochlear nerve microvascular decompression on tinnitus and vertigo

目的探讨第Ⅷ颅神经微血管减压术治疗眩晕、耳鸣的疗效。方法对12例耳鸣,其中8例合并眩晕患者实施了乙状窦后入路第Ⅷ颅神经微血管减压术,均随访6～48个月以判断治疗效果。结果第Ⅷ颅神经可见不同程度压迫,行微血管减压术后5例患者自觉耳鸣消失,5例患者自觉耳鸣减轻2级,2例患者耳鸣症状无改善;8例合并眩晕患者术后1周有3例眩晕症状消失,3例眩晕症状减轻,2例症状眩晕无改善。随访6个月以上5例耳鸣消失患者无复发,2例术后自觉耳鸣减轻患者6个月后耳鸣消失,3例术后自觉耳鸣减轻患者症状进一步改善,2例术后自觉耳鸣未减轻患者症状无变化;4例眩晕症状消失,2例眩晕症状减轻患者症状无明显改善,1例眩晕无改善患者症状在术后12个月后轻度改善,1例眩晕症状无改善。无不良反应发生。结论异常血管袢压迫第Ⅷ颅神经是眩晕、耳鸣的病因之一,显微血管减压术治疗微血管压迫综合征性眩晕、耳鸣是一有效、安全的治疗方法。

[Objective] To observe the effects of Microvascular Decompression （MVD） for tinnitus and vertigo induced by the VII Cranial Nerve Microvascular Comprssion （MVC） syndrome. [Methods] MVD of the V~ cranial nerve through the rectosigmoid approach was carried on 12 cases of ipsilateral tinnitus, including 8 cases with vertigo. All patients were followed-up 6-48 months to evaluate the treatment outcome. [Results] The VIn cranial nerve was seen varying degrees of oppression. During the early postoperative period, the tinni- tus were resolved or markedly improved in 10 patients, 2 cases ineffectiveness; 8 cases who suffered with tin- nitus and vertigo, after operated for one week, 3 of them were cured, 3 improved and 2 ineffectiveness. After 6 month followed up, 5 cases of tinnitus had cure, 2 cases of tinnitus alleviate patients felt cured, 3 cases of tinnitus alleviate patients felt improvement and 2 cases did not change; 4 cases of vertigo had cured, 2 cases of vertigo alleviate felt no significant improvement. 1 case of vertigo ineffectiveness patients felt improvement after 12 month followed up, but 1 case was ineffectiveness. [Conclusion] The evidence indicates that MVC of the vm cranial nerve is one of the causes of tinnitus and vertigo. MVD of the vestibulocochlear nerve is a safe and effective operation for these carefully selected tinnitus and vertigo patients.