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背景:三叉神经痛的发病原因中因牙源性感染因素所致,在继发三叉神经痛的病因学研究中愈来愈受到重视,并提出了颌骨骨腔病变学说。目的:研究颌骨病变性骨腔与三叉神经痛病因的关系。设计:以患者为研究对象,前后对照研究。单位:一所大学医院口腔颌面外科。对象:1994-02/2003-12青岛大学医学院附属医院口腔颌面外科收治的三叉神经痛患者45例,其中男15例,女30例,共发现病变性骨腔74个。方法:45例均行颌骨病变性骨腔清除术,术后应用视觉模拟评分法(VAS)对患者的疼痛程度进行评估。主要观察指标:①VAS评分。②手术刮出物病理学检查和细菌培养。结果:1次手术后疼痛消失者33例,占73.3%,两三次手术后疼痛消失者10例,占22.2%。疼痛缓解仍需要药物治疗维持2例,占4.5%。病理检查结果多为颌骨慢性炎症及肉芽组织。结论:颌骨病变性骨腔是引起三叉神经痛的主要病因之一。
BACKGROUND: The pathogenesis of trigeminal neuralgia is caused by the factors of odontogenic infection, and more and more attention has been paid to the etiology of trigeminal neuralgia. The theory of jaw cavity lesions is proposed. Objective: To study the relationship between pathological changes of mandibular cavity and trigeminal neuralgia. Design: Patients as the research object, before and after the control study. Unit: A University Hospital Oral and Maxillofacial Surgery. PARTICIPANTS: Forty-five cases of trigeminal neuralgia admitted to Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Medical College of Qingdao University from February 1994 to December 2003 were enrolled in this study. There were 15 males and 30 females, 74 lesions were found. Methods: All 45 patients underwent jaw osteoarthroplasty. Visual acuity score (VAS) was used to evaluate the degree of pain in the patients. MAIN OUTCOME MEASURES: ①VAS score. ② surgical scraping pathological examination and bacterial culture. Results: There were 33 cases of pain disappeared after one operation, accounting for 73.3%. There were 10 cases disappeared after two or three operations, accounting for 22.2%. Pain relief still need drug treatment to maintain 2 cases, accounting for 4.5%. Most pathological findings of chronic inflammation of the jaw and granulation tissue. Conclusion: The pathological changes of the jaw cavity are one of the main causes of trigeminal neuralgia.