舌咽神经痛的手术治疗与病因学探讨

目的探讨舌咽神经痛的病因，提高治愈率。方法采用局麻下乙状窦后进路舌咽神经根显微神经血管减压术。结果３０例舌咽神经痛，２９例疼痛立即消失，１例无效者于术后１月行第２次手术治愈。术后随访０．５－６年，疼痛均未再发作。结论舌咽神经痛的病因主要为血管压迫舌咽神经根，而颈内静脉孔区蛛网膜增厚粘连造成舌咽神经根的无法缓冲，受其动脉搏动性的压迫敏感区是病因学基础。认为舌咽神经根显微血管减压术是一种解除病因的治疗方法，治愈率高，复发率低。

Surgical treatment and etiology of glossopharyngeal neuralgia

Objective To research the causes of glosspharyngeal neuralgia, improve the cure rate. Method Microsurgical neurovascular decompression of glossopharyngeal nerve root by retrosigmoid sinus approach wereused. Results Among the patients treated by operative therapies, 29 patients are free from symptoms, 1 patientwhose symptoms had no change after operation but cured by second operation after one month. According the results of0.5 to 6 years of follow up postoperatively no patients have recurrence of the symptoms. Conclusions It showed thatvascular compression at root of glossopharyngeal nerve is the main cause of neuralgia. Due to adhesion and thicknessof arachnoid nearby foramen jugulare, pulsating compression of vascular can not be cusioned. This is the etiologic basis of gissopharyngeal neuralgia. We think that the neurovascular decompression of glossopharyngeal nerve root is aneffective method to remove the etiology, The cure rate is high and the reccurrence rate is low.