乙状窦后锁孔入路面神经微血管减压术的解剖研究及临床应用

Anatomy investigation and clinical application of retrosigmoid keyhole approach for facial nerve microvacular decompression

目的:探讨乙状窦后锁孔入路面神经微血管减压术的显微解剖及治疗面肌痉挛的临床应用。方法:应用1例尸头标本,经乙状窦后锁孔入路,在手术显微镜下对面神经及其周围血管逐层解剖,观察,测量及照相,临床应用该入路治疗面肌痉挛10例。结果:小脑下前动脉是主要的责任血管;经乙状窦后锁孔入路能够到达CPA区,充分暴露面神经、小脑下前动脉、小脑下后动脉和小脑上动脉。结论:血管压迫是面肌痉挛的主要病因,经乙状窦后锁孔入路可获得足够的操作空间,能够满足微血管减压术的需要。

Objective:To investigate microvacular decompression for treatment of hemifacial spasm through retrosigmoid key hole approach and the anatomic study of the facial nerve in the cerebellopontine angle.Methods:Ten adult cadaver heads, fixed with formalin, were used in this study.The trans-suboccipital retrosigmoid key hole approach to the CPA region was simulated.Dissections were observed and photographed gradually.And 10 patents with hemifacial spasm were treated via trans-suboccipital retrosigmoid key hole approach.Results:Anterior inferior cerebellar artery is the major offending vessel.Via trans-suboccipital retrosigmoid key hole approach, The facial nerve、AICA、PICA 、 SCA could be easily observed.Conclusion:Vascular compression may be the main cause of HFS.Retrosigmoid key hole approach provide enough operating space for microvacular decompression.