桥小脑角脑神经病变显微手术510例病因分析

A Clinical Analysis of causes Responsible for Neural Lesion in Cerebellopontine Angle

目的 总结桥小脑角脑神经病变 ５１０例显微手术的经验，并对病因进行分析。方法 经乙 状窦后入路进入桥小脑角，在手术显微镜下对有关神经构成压迫和各种病灶分别给予相应的减压等处 理。结果 桥小脑角脑神经病变５１０例全部治愈。术中发现因责任血管压迫者４６６例，占９１．３７％；肿瘤 １５例，占２．９４％；蛛网膜粘连者２９例，占５．６９％。结论 桥小脑角脑神经病变５１０例，致病因素以责任 血管压迫为主，部分为肿瘤压迫，而蛛网膜粘连致病者亦占相当比例；蛛网膜粘连是引起舌咽神经痛的 重要因素。

Objective To investigate the causes responsible for cranial nerve le-sion in cerebellopontine angle based on clinical analysis of 510 cases received micro-surgery in this area. Methods Retrosigmoid sinus approach was adopted to go into cerebellopontine angle during the surgical procedure to find out the neural lesion and re-lated causes for them in the angle area. Once the causes were found, they were removed through surgical treatment. Results Among the cases studied, the lesion was caused by blood vessel compressing in 466 patients (91. 37%), by skull base tumor in 15(2. 94%) and by arachnoid synechia in 29(5. 69%). Conclusion The main cause respon-sible for cranial nerve lesion in cerebellopontine angle may 'be compressing caused by blood vessel for most cases with the condition, and less important is the skull base tu-mor for the lesion. Furthermore, arachnoid synechia is an important factor for glos-sopharyngeal neuralgia.