神经内镜下微血管减压治疗原发性三叉神经痛

目的:探讨神经内镜辅助微血管减压治疗原发性三叉神经痛(trigeminal neuralgia,TN)的疗效。方法:经乳突后锁孔入路,在神经内镜下行三叉神经微血管减压术,分离责任血管并充分游离神经周围与神经有粘连的蛛网膜后,用小自体筋膜片垫在责任血管与三叉神经根之间,将两者隔离。结果:17例术后疼痛立即消失者13例,术后3天疼痛消失者4例。术后面部麻木1例,轻度面瘫1例,术后3个月均恢复。无继发性颅内出血、术后感染及脑脊液漏情况,无死亡病例。术后随访6个月~4年,复发1例。结论:神经内镜技术在原发性TN微血管减压术中,具有操作视野清晰,避免遗漏责任血管、损伤血管、神经和脑组织,术后并发症少、治愈率高的特点,是治疗原发性TN的最佳手术方法之一。

Neuroendoscope or microvascular decompression assisted by an neuroendoscope for treatment of trigeminal neuralgia

Objective:To investigate the clinical application of microvascular decompression assisted by an neuroendoscope for treatment of trigeminal neuralgia.Methods:Seventeen cases of trigeminal neuralgia were treated by retromastoid key hole approach with microvascular decompression assisted by an neuroendoscope.The duty vessel and the arachnoid around the nerve were dissociated,then a fasciai patch was placed between the duty vessel and the trigeminus.Results:Thirteen patients were completely cured immediately af...