眶下管减压术治疗三叉神经痛(Ⅱ支)的初步报道

Decompression of the Infraorbital Canal to Treat Trigeminal Neuralgia(Ⅱ)

目的 :通过评价眶下管减压术治疗三叉神经痛 (Ⅱ支 )的临床疗效 ,初步探讨三叉神经痛的颅外病因。方法 :31例眶下神经和 (或 )上牙槽前神经支配区域疼痛患者行眶下管减压术 ,问卷随访 30例 ,随访期 1～ 10个月 ,平均 6 .1个月。结果 :30例患者中“优”为 5 0 % (15 / 30 ) ,“良”为 36 .7% (11/ 30 ) ,“差”为 13.3% (4 / 30 )。手术成功率包括“优”、“良”的患者为 86 .7% (2 6 / 30 ) ,疼痛缓解的时间均为术后 2 4h以内。结论 :眶下管减压术的疼痛缓解成功率高、并发症少 ,在排除了其他部位压迫后可作为治疗三叉神经痛 (Ⅱ支 )的首选方法 ,其临床的高成功率也为三叉神经痛的颅外骨管。

Objective: To evaluate the outcomes of the decompression of the infraorbital canal in treating trigeminal neuralgia(Ⅱ),and further to study the pathogenesis out of foramen ovale. Methods: 31 patients with the trigeminal neuralgia(Ⅱ) which the infraorbital and anterior superior alveolar nerves are involved were treated by the decompression of the infraorbital canal. 30 patients were followed up. The period of follow-up was 6.1 months in average(1～10 months). Results: Among 30 patients, 50%(15/30) cases had an excellent response, 36.7%(11/30) cases had a good response, and 13.3%(4/30) cases had a poor response. The postoperative successful rate( excellent and good) was 86.7%(26/30). The relief time of 26 patients was in 24 hours after operation. Conclusions: Decompression of the infraorbital canal has higher successful rate and lower incident rate of the complications. It can be used as a first-chosen method to treat trigeminal neuralgia(Ⅱ) excluding the compression on other parts of trigeminal nerve. The clinic experiences also support the hypothesis that the compression in bone canal/foramen can also induce trigeminal neuralgia.