经皮穿刺微球囊压迫半月节治疗继发性三叉神经痛

Percutaneous microballoon compression on the gasserian ganglion for secondary trigeminal neuralgia

目的观察经皮穿刺微球囊压迫半月节（PMC）治疗继发性三叉神经痛的临床疗效。方法回顾性分析57例采用PMC微创外科治疗继发性三叉神经痛病人的临床资料,并进行随访。结果治疗后疼痛即刻完全缓解52例,部分缓解3例,总有效率为96.5%;疼痛无缓解2例。术后同侧轻度感觉减退52例（91.2%）,同侧张口受限、咀嚼肌无力52例（91.2%）,多数于1~3个月内症状消失或耐受;围手术期口角疱疹7例（12.3%）,术后1周左右恢复。无严重手术并发症发生。随访为10~99个月,平均疼痛缓解时间46个月,复发11例（19.3%）。结论 PMC是治疗继发性三叉神经痛的有效微创方法,适用于不适合或不愿意开颅手术,经历多种方法治疗不理想,或复发的继发性三叉神经痛病人。

Objective To observe the clinical effect of percutaneous microballoon compression（PMC） on the gasserian ganglion for the treatment of secondary trigeminal neuralgia（ STN）. Methods Clinical data of patients with 57 STN undergoing PMC minimally invasive surgery were analyzed retrospectively, and follow-up analysis of all patients were conducted. Results Instant complete pain remission was achieved in 52 patients, partial remission in 3 and no remission in 2 after surgery, and the total rate was 96.5%. Mild ipsilateral hypesthesia occurred in 52 patients（91.2%）, and ipsilateral limitation of mouth opening and masticatory muscle weakness in52（91.2%） after the operation, and most of the symptoms disappeared or were tolerated within 1 to 3 months. Angulus oris herpes occurred in 7 patients（ 12. 3 %） perioperatively, who recovered around 1 week after operation. No serious surgical complications occurred. All the patients were followed up from 10 to 99 months, and the average pain relief time was 46 months, and 11 patients（19.3%） recurred. Conclusions PMC is an effective and minimally invasive method for STN, and it is appropriate for patients who are unsuitable or unwilling for craniotomy, for patients undergoing a variety of unsatisfactory treatment, and for patients with recurrent STN.