微血管减压术中面 听神经和小脑的保护及意义

目的：总结开颅微血管减压术中面、听神经和小脑保护的经验。方法回顾性分析853例颅神经疾病微血管减压术的病例，其中三叉神经痛532例、面肌痉挛295例、舌咽神经痛26例。结果本组发生小脑半球血肿1例（0.12%），听力下降或耳鸣16例（1.88%），直接或迟发面瘫共30例（3.52％），无死亡及其它严重并发症发生。结论良好的手术入路策略和显微操作技巧、避免过度牵拉颅神经和术中常规运用电生理监测，可减少手术相关并发症。

ObjectiveThis study aimed to discuss how to protect carnival nerveⅦ ＆Ⅷ and cerebellum in microvascular decompression. MethodsWe retrospectively analyzed 853 MVD in recent 3 years,including 532 trigeminal neuralgia cases,295 hemifacial spasm and 26 glossopharyngeal neuralgia.Results The cerebellar hemorrhage occured in 1 case,hearing loss or tinnitus in 16 and facial paralysis occurred in 30 out of 853 cases. There was no death or any other severe complication in our group.ConclusionThe excellent surgical approach strategies, micromanipulation techniques,avoidance of excessive traction cranial nerve surgery and routine use of electrophysiological monitoring can reduce surgery-related complications.