舌咽神经痛显微外科手术治疗后的远期疗效

Long-term follow-up results of microsurgical treatment for glossopharyngeal neuralgia

目的 探讨舌咽神经痛的有效手术方法及远期疗效。 方法 1986年至 1998年间对2 1例舌咽神经痛患者进行了外科手术治疗 ,其中显微血管减压术 5例 ,血管减压术同时行舌咽神经根及迷走神经根上部 1～ 2根丝切断术 4例 ,舌咽神经根及迷走神经根上部 1～ 2根丝切断术 12例。 结果 2 1例患者术后疼痛全部消失 ,3例出现偶发性干咳 ,其中 1例伴轻度声嘶及吞咽功能障碍。全部病例平均随访时间为 7 2年 ,疼痛无 1例复发。 结论 显微血管减压术、舌咽神经根及迷走神经根上部 1～ 2根丝切断术或两种术式合用均为治疗舌咽神经痛的有效治疗方法 ,采取哪种手术方式应根据术中有无责任血管压迫及责任血管压迫的方式而定。

Objective[WT5”BZ] To discuss effective surgical methods for the treatment of glossopharyngeal neuralgia. [WT5”HZ]Methods[WT5”BZ] During 1986 1998, 21 patients with glosssopharyngeal neuralgia were treated microsurgically. Of whem, 5 patients were treated by microvascular decompression(MVD), 4 by MVD combined with rhizotomy of glossopharyngeal nerve root and upper 1st to 2nd rootlets of vagus nerve root,and 12 by rhizotomy of glossopharyngeal nerve root and upper 1st to 2nd rootlets of vagus nerve root. [WT5”HZ]Results[WT5”BZ] Neuralgia disappeared in all patients postoperatively. In 3 patients, occasional coughing episodes occurred postoperatively. One of the 3 patients also suffered from mild hoarseness and swallowing difficulty. All patients were followed up on average 7.2 years with no recurrence. [WT5”HZ]Conclusions[WT5”BZ] MVD, rhizotomy of glossopharyngeal nerve root and upper 1st to 2nd rootlets of vagus nerve and their combination are effective for the treatment of glossophryngeal neuralgia. Operative methods should be chosen according to the following two points: compression of nerve roots by affected vessels or not; and the condition of compression. [WT5”HZ]