三叉神经痛外科治疗的现状及进展

三叉神经痛确切发病机制及病因尚不清楚，缺乏理想的外科治疗方法。比较目前诸多手术治疗方法，各有优缺点。经过长期随访和对照研究后认为，对一般状况较好，年龄不大的病人首选三叉神经根微血管减压术。老年人不能耐受手术，拒绝手术，愿意接受面部感觉减退的病人选择经皮射频热凝术。微血管减压或射频热凝术后复发者可再次行射频热凝治疗。三叉神经感觉根切断、三叉神经脊髓束切断和甘油注射治疗已少用或弃用。本文综述了目前常用的几种手术方法的研究现状和进展。

Actuality and progress in surgical treatment of classic trigeminal neuralgia

The exact etiology of classic trigeminal neuralgia (TN) remains unkown. Surgical methods for the treatment of TN are numerous. Long-term follow-up and comparison studies have shown that microvascular decompression is the first option for younger patients who wish to avoid any facial dysesthesia but percutaneous radiofiequency thermocoagulation is a good choice for the elderly who are unwilling or cannot stand surigical operation. In case of recurrences, radio frequence thermocoagulation can be performed once again. Peripheral neurectomy, spinal tractomy of the trigeminal nerve and glycerol gangliolysis are only rarely employed or abandoned in the present neurosurgery.