电生理监测对三叉神经后根纤维的解剖学定位研究

目的 通过电生理监测,研究三叉神经各分支纤维在后根的空间位置.方法 选择手术的20例三叉神经痛患者,分别刺激三叉神经进入脑干区的头端、尾端、背侧、腹侧,在眶上孔、眶下孔、颏孔同时记录复合神经动作电位,观察外周分支的波形出现情况.结果 刺激部位不同,波形在不同分支的出现情况也不同.根据电生理监测,V1支主要位于头端,V2支主要位于头端背侧和腹侧,V3支主要位于尾端腹侧和背侧,与疼痛部位及术中所见血管压迫位置一致.结论 通过逆向电刺激记录复合神经动作电位,可以帮助定位三叉神经各分支纤维在后根的位置,用于微血管减压术中能帮助判断责任血管,为血管减压提供参考.

Anatomical study on posterior root fibers of trigeminal nerve using electrophysiological monitoring

Objective The spatial location of nerve fibers of various trigeminal branches in the posterior root were studied using electrophysiological monitoring.Methods This clinic study included 20 cases of trigeminal neuralgia patients receiving microvascular decompression surgery.During operation,the rostral,caudal,dorsal and ventral parts of the root entry zone of trigeminal nerve were stimulated respectively.The compound nerve action potentials were recorded in supraorbital,infraorbital and mental foramina simultaneously.Then the waves recorded from each peripheral branch were analyzed.Results Different parts stimulated,the occurrence of the compound nerve action potential wave was different.According to electrophysiological monitoring,the V1 fibers were mainly located in the rostral part,the V2 fibers in the rostral dorsal and ventral parts,and the V3 fibers in the caudal ventral and dorsal parts.The electrophysiological data were in accordance with the symptoms and the vascular compression location.Conclusion Recording compound nerve action potentials through antidromic electrical stimulation can help to locate the various branches of the trigeminal nerve in the posterior root,to identify causal vessel,and to provide reference for microvascular decompression surgery.