经耳后小切口入路手术治疗原发性三叉神经痛

Surgical treatment of primary trigeminal neuralgia through small incision behind the ear

回顾分析3000例原发性三叉神经痛患者微血管减压术或三叉神经感觉支部分切断术疗效。其结果显示,临床治愈率达98.66%(2863例)、有效0.55%(16例)、无效0.45%(13例)、复发0.35%(10例);术后并发症主要为低颅压综合征(1215例占40.50%),以及脑水肿(42例占1.40%)、脑出血(6例占0.20%)和缺血性卒中(2例占0.07%)。微血管减压术仍是目前治疗原发性三叉神经痛有效且安全的首选手术方式,绝大多数患者术后疼痛症状可消除或缓解。

A total of 3000 cases with primary trigeminal neuralgia were treated in our department from October 2005 to November 2013 by microvascular decompression or partial amputation of the sensory branch of trigeminal nerve. The clinical cure rate reached 98.66% （2863 cases）, and the effective rate was 0.55% （16 cases）, ineffective rate 0.45% （13 cases）. The recurrence rate was about 0.35% （10 cases）. The main postoperative complication was intracranial hypotension syndrome （40.50%, 1215 cases）, which disappeared 2 or 3 d later. The other serious complications included encephaledema （1.40%, 42 cases）, cerebral hemorrhage （0.20%, 6 cases） and ischemic stroke （0.07%, 2 cases）. In conclusion, microvascular decompression is an effective and safe operation method in the treatment of primary trigeminal neuralgia, and most patients＇ pain can be eliminated or alleviated after surgery.