影像后处理技术辅助乙状窦后入路手术治疗原发性三叉神经痛

目的 探讨影像后处理技术辅助乙状窦后入路微血管减压术（MVD）治疗原发性三叉神经痛（PTN）的安全性和有效性。方法 回顾性分析2020年12月至2021年4月影像后处理技术辅助乙状窦后入路MVD治疗的10例PTN的临床资料。9例应用3D-Slicer软件三维重建技术、1例利用DSA影像后处理技术定位关键孔，经乙状窦后入路手术。结果 无手术死亡病例，无术后出血、感染、皮下积液；术后出现暂时性眩晕伴听力下降1例。9例术后疼痛即刻缓解；1例未缓解，二次术后疼痛消失，出现感觉麻木。术后随访6～24个月，无复发；1例仍有感觉麻木，无面瘫、听力下降、行走不稳。结论 利用影像后处理技术可精确定位关键孔，并完整游离骨瓣，为MVD提供足够的显露空间，有助于减少感染、脑脊液漏发生率，手术效果良好。

Application of imaging post-processing techniques to microvascular decompression through retrosigmoid approach for primary trigeminal neuralgia

Objective To explore the accuracy of imaging post-processing techniques in locating the key holes during craniotmy and to evaluate the safety and efficacy of microvascular decompression (MVD) via retrosigmoid approach for the patients with primary trigeminal neuralgia (PTN). Methods A retrospective analysis was performed on the clinical data of 10 patients with PTN treated in our department from December 2021 to April 2022. Before MVD, the imaging post-processing techniques were used to locate the key holes. Results There was no intraoperative death or postoperative bleeding. Immediate relief of pain was achieved in 9 patients after the surgery and was not in 1 patient who underwent a second operation with sensory root electrocautery. There was no postoperative infection and subcutaneous bleeding. One patient had temporary vertigo and hearing loss after operation. The postoperative follow-up ranged from 6 months to 24 months. There was no recurrence. One patient had numbness without facial paralysis, hearing loss, or walking instability. Conclusions Imaging post-processing techniques can be used to accurately locate the key holes and make a complete bone flap during opening a fully exposed operating window for MVD, which is helpful to reducing the incidence of postoperative infection and cerebrospinal fluid leakage and obtaining good surgical outcomes.