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三叉神经痛神经高位切断切除术(附539支/415例报告)
引用本文:姜晓钟,赵云富,邹爱萍,苗林,刘渊.三叉神经痛神经高位切断切除术(附539支/415例报告)[J].第二军医大学学报,2001,22(12):1169-1170.
作者姓名:姜晓钟  赵云富  邹爱萍  苗林  刘渊
作者单位:第二军医大学长征医院口腔科,
基金项目:军队科研项目,98M084,
摘    要:目的:解除患三叉神经痛,提高神经切断术的治疗效果,减少术后复发。方法:患全身麻醉,口腔或健侧鼻腔插管,患侧口腔前庭切口,切断近颅端神经,切除远颅端部分神经。结果:术后控痛率100%,上颌神经痛术后复发3例,下颌神经痛术后复发11例,术后复发支率2.85%(14/492),复发例率3.69%(14/379),分别再行鼻腭神经,腭大神经,颏神经/颊神经及舌神经襻切除术,术后疼痛消失。结论:神经切断术“高位”比“低位”好,多支比单支好,切断+部分切除比单纯切断好,高位切断与神经周围支部分切除可能减少术后复发。

关 键 词:三叉神经痛  神经外科手术  神经高位切断切除术  术式  疗效
文章编号:0258-879X(2001)12-1169-02
修稿时间:2001年4月13日

Transoral approach neurectomy at high position in treatment of trigeminal neuralgia:A report of 539 branches in 415 patients
JIANG Xiao Zhong,ZHAO Yun Fu,ZOU Ai Ping,MIAO Lin,LIU Yuan.Transoral approach neurectomy at high position in treatment of trigeminal neuralgia:A report of 539 branches in 415 patients[J].Academic Journal of Second Military Medical University,2001,22(12):1169-1170.
Authors:JIANG Xiao Zhong  ZHAO Yun Fu  ZOU Ai Ping  MIAO Lin  LIU Yuan
Abstract:Objective: To study the treatment of trigeminal neuralgia with high position neurectomy. Methods: Trans pterygopalatine fossa maxillary neurectomy and trans pterygomandibular space mandibular neurectomy were carried out under general anesthesia with resection part of extracranial nervous tissues far away from the skull. Results: The rate of the controlling pain was 100%. There were 3 cases had recurrence after the operation of the maxilla nerve and 11 cases after the operation of mandible nerve. The recurrence rate of the branch was 2.85% (14/492) and the rate of the case was 3.69%(14/379). After resection of the nasopalatine branch nerve, the palate nerve, the mental nerve, the buccal nerve and the lingual nerve, the pain disappeared. All cases were retreated surgically without auident. Conclusion: The higher position neurectomy is better than the lower position, and the more the branches are the better. Severance plus part resection is better than pure severance. The severance of the high position and the resection of the nerve branches can reduce recurrence.
Keywords:trigeminal neuralgia  neurosurgery
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