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目的探讨经小脑水平裂-小脑桥脑裂入路治疗三叉神经痛的经验教训。方法回顾性分析经小脑水平裂-小脑桥脑裂入路治疗的连续133例三叉神经痛病例。结果所有患者均可顺利或较顺利的分开小脑水平裂外侧部和小脑桥脑裂上支,岩静脉均得到妥善处理,128例有明确责任血管压迫,5例可疑血管压迫,均行个体化围套式减压,术后立即止痛129例,术后3～5天止痛3例,1例疼痛减轻约50%。无死亡,1例听力下降,1例面部轻瘫,11例出现口唇疱疹,8例患侧面部轻微麻木。1例(0.75%)术后10个月复发。结论经小脑水平裂——小脑桥脑裂入路治疗三叉神经痛,可以避免传统的枕下乙状窦后入路三叉神经感觉根入桥脑处显露不良的缺陷,提高有效率,减少听力下降、面瘫等并发症的发生。
Objective To investigate the experience of treatment of trigeminal neuralgia by cerebellar horizontal fissure-pontine psorama approach. Methods A retrospective analysis of 133 patients with trigeminal neuralgia treated by the cerebellar horizontal split-pontine palliative approach was performed. Results All patients could be successfully or more smoothly separated from the lateral crest of cerebellar fissure and the branch of pallidopilatoplasty, and the petrosal vein were properly treated. 128 patients had definite responsibility for vascular compression and 5 suspected vascular compression. Nail decompression, immediate postoperative analgesia in 129 cases, 3 to 5 days after surgery pain relief in 3 cases, 1 case of pain relief about 50%. No death, 1 case of hearing loss, 1 case of facial paresis, 11 cases of cold sores, and 8 cases of lateral numbness. One patient (0.75%) relapsed 10 months after operation. Conclusions The treatment of trigeminal neuralgia through the cerebellar fissure-pontine palliative approach can avoid the traditional suboccipital sigmoid sinus posterior approach. The sensory root of the trigeminal nerve impairs the defects at the pons and brains to improve the efficiency and reduce the hearing loss , Facial paralysis and other complications.