经上颌窦内镜翼腭窝三叉神经上颌支部分切除术

Approach to the maxillary sinus, the peterygopalatofossa for resecting maxillary nerve under the endoscopy

目的 :探讨一种有效治疗年老体弱患者单独原发性三叉神经上颌支痛的手术方法。方法 :对 39例 4 0侧原发性三叉神经上颌支痛的年老体弱患者在内镜下经上颌窦至翼腭窝在圆孔处切除上颌神经 0 .5～ 1.0cm。结果 :术后全部病例疼痛消失 ,经 2年以上观察 ,术侧上颌神经分布区麻木、感觉异常 ,但无疼痛 ,2例分别于术后 5个月和 12个月出现术侧下颌神经痛 ,上颌区无痛。结论 :内镜下经上颌窦至翼腭窝行三叉神经上颌支部分切除术适用于年老体弱、长期单独局限于上颌神经痛的患者 ,但要求其上颌窦腔有一定程度发育和无炎症 ,手术远期效果好 ,避免了开颅手术的危险 。

Objective:This paper presents a method for treating maxillart neuralgia, the second division of trigeminal nerve, in the weak aged.Method:Thirty-nine cases with forty trigerminal euralgia were treated from 1996 to 2001.All patients were treated through the maxillary sinus, the peterygopalatofossa for resecting maxillary nerve with endoscopic surgery.Result:The pain of all patients was relieved after operation and no recurrence of neuralgia was occurred in more than 2-years follow-up.Conclusion:This method had the advantages of avoiding to operate craniotomy, no complications, performing easily and the ideal trentments remained.