锁孔下颅神经显微血管减压手术技巧及疗效分析：附513例报告

Curative effect and surgical skill of microvascular decompression via keyhole for cranial neuropathy： a report of 513 cases

目的 总结锁孔下微血管减压手术治疗原发性颅神经疾患的手术技巧及疗效.方法 回顾性分析2005年1月~2016年1月采用微血管减压术治疗原发性颅神经疾患513例（三叉神经痛263例、面肌痉挛234例、舌咽神经痛患者16例）的手术技巧及并发症的防治.结果 本组无死亡病例及其他严重并发症发生,三叉神经痛患者手术治愈率为94.67%,面肌痉挛手术治愈率为97.01%,舌咽神经痛治愈率为75.00%.结论 显微血管减压术是治疗原发性颅神经疾患的可靠方法,熟练的显微外科技术和丰富的手术经验及对于解剖的熟悉程度是手术治疗颅神经疾患的基础.

Objective To summarize the curative effect and surgical skills of microvascular decom-pression（MVD） via keyhole for the treatment of cranial neuropathy.Methods Totals of 513 cases of primary cranial neuropathy under MVD treatment between January 2005 and January 2016 were retrospectively analyzed, which included 263 trigeminal neuralgia cases, 234 hemifacial spasm cases and 16 glossopharyngeal neuralgia cases. The surgical techniques and prevention of postoperative complications were analyzed.Results There was no death or other severe complications in our group.The postoperative cure rate with trigeminal neuralgia was 94.67%,97.01% with hemifacial spasm and 75.00% with glossopharyngeal neuralgia.Conclusions MVD is a reliable method for primary cranial neuropathy,what is more, skilled microsurgical techniques, rich microsurgical ex-perience and familiarity with the anatomy are the foundation of the surgical treatment for cranial neuropathy.