改良乙状窦后进路舌咽神经切断术治疗舌咽神经痛

Glossopharyngeal neuroutomy by improved retrosigmoid approach

目的 :探讨提高手术治疗舌咽神经痛疗效的手术进路。方法 :对 8例本病患者取改良乙状窦后进路 ,进入桥小脑角 ,暴露颈静脉孔 ,在手术显微镜下对颈静脉内孔周围探查 ,并切断舌咽神经 ;如并发三叉神经痛者同时行三叉神经感觉根部分切断。结果 :8例术后舌咽神经痛 (其中 2例并发三叉神经痛 )症状均完全消失 ,无并发症发生。随访 2～ 7年无复发。结论 :舌咽神经痛经改良乙状窦后进路行颈静脉内孔探查 ,并切断舌咽神经根 ,可以获得解除疼痛。

Objective:To explore a surgical approach to improve the operation effect of glossopharyngeal neuralgia (GPN).Method:In 8 cases with GPN, the improved retrosigmoid approach was adopted to access the cerebellopontine angle for exposing the jugular foramen and its adjacent tissues so as to cut off the glossopharyngeal under microscope. The sensoryrizotomy of trigemlind nerve was also performed if there was a trigeminal neuralgia.Result:All the symptom of pain in 8 cases with GPN disappeared after operation with no complication occurred. There was no recurrence following up for 2～7 years.Conclusion:By improved retrosigmoid approach,it is easy to explore the jugular foramen and cut off the glossopharyngea for treating GDN.