神经内镜辅助原发性三叉神经痛显微血管减压术

Endoscopic microvascular decompression for diopathic trigeminal neuralgia

目的探讨神经内镜在原发性三叉神经痛显微血管减压术中的应用价值。方法回顾性分析2010年3月~2013年12月58例神经内镜辅助原发性三叉神经痛显微血管减压术患者的临床资料、手术资料及随访结果。采用神经内镜在手术中观察并判定责任血管及置入垫棉的位置。结果 58例患者中手术证实存在责任血管压迫者54例（93.1%）,其中5例（8.6%）显微镜下未发现的责任血管则通过神经内镜发现。本组患者术后未见颅内出血、脑脊液漏及面瘫等严重手术并发症,55例患者（94.8%）疼痛消失,2例（3.4%）疼痛减轻,总有效率为98.3%;术后2年的复发率为5.3%。结论神经内镜辅助原发性三叉神经痛显微血管减压术有助于明确评判责任血管后做到彻底减压,能够提高手术疗效及减少术后并发症。

Objective To explore the value of endoscope in microvascular decompression （MVD） for idiopathic trigeminal neuralgia （ITN）.Methods The clinical data,operative data and follow-up results of 58 patients with ITN ,who underwent endoscope-assisted MVD from March ,2010 to December , 2013 were analyzed retrospectively .The endoscope was used to distinguish the responsible vessels and confirm the location of Teflon in MVD .Results No severe complications such as intracranial hemorrhage , cerebrospinal fluid leakage and facial paralysis occurred and the responsible vessels of 54 cases（93.1%） were found in 58 ITN patients.The responsible vessels of 5 cases（8.6%） were missed under the microscope , but they were found by endoscope .The effective rate was 98.3% in 58 ITN cases, with 55 cases（94.8%） completely relief and 2 cases（3.4%） little residual pain.3 cases（5.3%） recurred in 2 years after operation.Conclusions Endoscope-assisted MVD for ITN has contributed to judge responsible vessels and place telflon correctly .It can improve the surgical curative effects and reduce postoperative complications .