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目的:探讨三叉神经痛型桥小脑角胆脂瘤的发生机制、临床表现和治疗原则。方法:回顾性总结21例以原发典型三叉神经痛为主要表现的胆脂瘤患者的临床表现、肿瘤生长部位与大小、手术入路与技巧、结果和术后并发症等资料。结果:肿瘤全切16例,次全切5例。所有患者均表现为同侧三叉神经痛。术中发现10例肿瘤将三叉神经包绕在瘤内。术后三叉神经痛均消失,面部感觉减退2例,听力减退1例;1例疑似无菌性脑膜炎。结论:桥小脑角区胆脂瘤与三叉神经痛的关系复杂,应采取手术治疗,术中根据肿瘤和周围结构的关系以确定是否全切,术后注意无菌性脑膜炎等并发症。
Objective: To investigate the pathogenesis, clinical manifestation and treatment of Trigeminal neuralgia of trigeminal neuralgia. Methods: The clinical manifestations, tumor location and size, surgical approaches and techniques, results and postoperative complications of 21 cholesteatoma patients with primary trigeminal neuralgia were retrospectively reviewed. Results: 16 cases of complete tumor resection, subtotal 5 cases. All patients showed ipsilateral trigeminal neuralgia. Tumor found in 10 cases of Trigeminal nerve in the tumor. Trigeminal neuralgia disappeared after surgery, 2 cases of facial sensation decreased, 1 case of hearing loss; 1 case of suspected aseptic meningitis. Conclusions: The relationship between the cerebellopontine angle region cholesteatoma and trigeminal neuralgia is complicated. Surgical treatment should be taken. According to the relationship between the tumor and the surrounding structures during surgery, to determine whether the total cut and postoperative complications such as aseptic meningitis.