CT三维重建在三叉神经痛微血管减压术中的应用

目的探讨CT三维重建在三叉神经痛显微血管减压术(MVD)术中的应用,为精准手术提供良好的准备。方法选择行三叉神经痛显微血管减压术的患者83例,术前应用3Dslicer软件进行颅骨CT三维重建,在颅骨内横窦沟与乙状窦沟结合处下缘模拟出“关键孔”并在颅骨外表面标记,然后测量“关键孔”与星点及二腹肌沟顶点的距离,术中根据这两组距离指导“关键孔”的定位。结果本组患者无横窦或乙状窦损伤,77例术中通过“关键孔”清晰显露横窦与乙状窦结合处,未清晰显露6例。结论应用3Dsliker进行颅骨CT三维重建的方法可以客观、准确地定位“关键孔”,缩短手术时间,减少颅骨缺损,降低静脉窦损伤的风险。

Objective To explore the application of three-dimensional CT to craniotomy of microvascular decompression for trigeminal neuralgia,and provide a good preparation for precision surgery.Methods 83 patients with trigeminal neuralgia operated via microvascular decompression were enrolled proactively.3Dsilcer was used to reconstruct 3-D skull of the patients before operation,a virtual"key hole"was found on the margin of transverse sigmoid sinus groove junction on the internal view of skull and marked on the external surface of the skull.The distance between the"key hole"and the star point and the distance between the"key hole"and the superior end point of digastric groove were measured.Based on these tAvo distances,the location of the key hole was determined during operation.Results Transverse-sigmoid sinus junction was exposed clearly in the"key hole"in 77 cases while it was not in 6 cases.No transverse or sigmoid sinus injury occurred.Conclusion Using 3Dslilcer to reconstruct 3-D skull can provide objective and accurate position for"key hole",which can shorten the operation time,reduce the skull defect and reduce the risk of sinus injury.