三叉神经痛及其术后复发的病理学基础研究

Pathological basis of trigeminal neuralgia and its recurrence after neurectomy

目的 观察正常对照组和三叉神经痛组及下牙槽神经离断后的颏神经超微结构变化 ,探寻三叉神经痛及其术后复发的形态学基础。方法 对 8例颏神经进行电镜观察 ,其中 2例为正常对照 ,6例为罹患三叉神经痛 (Ⅲ )患者。结果 三叉神经痛患者标本中脱髓鞘变严重 ,无髓鞘神经纤维数量减少 ,下牙槽神经离断后 ,颏神经束中仍可见少量神经纤维呈“簇”状分布。结论 脱髓鞘变及无髓鞘神经纤维的减少可能是三叉神经痛的病理学基础 。

Objective To observe the difference of mental nerve ultrastructure in the normal cases, cases with trigeminal neuralgia and cases who received neurectomy of the inferior alveolar nerve years ago, and to probe into the pathomorphology of trigeminal neuralgia and its recurrence. Methods To observe the ultrastructure of eight mental nerves with electron microscopy, two from normal controls, and six from trigeminal neuralgia(Ⅲ)patients. Results Among the specimens, demyelination was severe and the unmyelinated fibers decreased in number, furthermore, a few nerve fibers were still seen in the mental nerve bundles whose inferior alveolar nerve were transected years ago. Conclusion Both demyelinating and decrease of unmyelinated fibers may be the pathological basis causing trigeminal neuralgia, and the remnant nerve fibers may be the peripheral cause of its recurrence.