神经内镜在三叉神经痛显微血管减压术中的应用价值

目的 探讨神经内镜辅助显微手术治疗原发性三叉神经痛的实用性及其优势.方法 回顾性分析62例应用神经内镜辅助显微血管减压手术治疗三叉神经痛的患者的临床资料和疗效.手术方式为经枕下乙状窦后入路,并在垫入Teflon垫片前后均置入30.神经内镜进行多角度观察,主要目的是观察神经全程及其周围血管,判别责任血管,并观察确认垫片位置,协助垫片调整.结果 62例三叉神经痛患者术后59例疼痛消失,3例疼痛减轻,无一例发生颅内感染、出血等并发症.结论 应用神经内镜辅助显微手术治疗三叉神经痛可以消除桥小脑角区显微手术的外科解剖死角,有助于正确地判断责任血管以及置入Teflon垫片,避免遗漏责任血管,协助调整垫片位置,能提高手术的疗效。

Application of neuroendoscope - assisted microvascular decompression for trigeminal neuralgia

Objective To assess the application of neuroendoscope in microvascular decompression （MVD） for treatment of idiopathic trigeminal neuralgia （ITN）.Methods Clinical data were collected from sixty-two ITN patients receiving neuroendoscope-assisted microvascular decompression from September 2012 to February 2014.Before and after Teflon inplantation,a neuroendoscope was placed at an angle of 30 degrees through suboccipital retrosigmoid approach to visualize the entire nerve,distinguish the responsible vessels and confirm the location of Teflon.Results After the operation,59 of 62 ITN patients （95.16%） reported disappearance of pain,while 3 complained pain relief.No severe complications including intracranial infection or hemorrhage occurred.Conclusions The application of endoscope in microvascular decompression can improve the surgical view in the cerebellopontine angle region and surgical efficacy by facilitating the correct determination of responsible vessels and proper implantation of Teflon.