目的 :探讨既能根治三叉神经痛 ,又能保留其神经生理功能的功能性三叉神经痛手术方案。方法 :采用耳后小切口乙状窦后入路行三叉神经血管减压松解梳理术 ,治疗三叉神经痛 1 1 2例 ,包括桥小脑角区域肿瘤继发三叉神经痛 1 5例。结果 :全部病例均一次手术治愈 ,保全了三叉神经生理功能 ,随访 3个月～ 3年 ,近期治愈率 1 0 0 % ,无 1例复发 ,仅部分病例留有面部麻木 (此组病例因术前均做过无水酒精封闭等治疗 )。术中发现责任血管 91例 ,神经受压 1 0 6例 ,占 94.6%。结论 :血管减压松解梳理术是治疗三叉神经痛理想的功能性术式。应用冷光源导光束直视手术 ,有利于责任血管的发现。处理好岩静脉能提高手术成功率。责任血管是指压迫三叉神经感觉根入根区敏感区的血管 Objective: To explore the functional trigeminal neuralgia surgical approach that can both cure trigeminal neuralgia and retain its neurophysiological function. Methods: A total of 112 cases of trigeminal neuralgia, including 15 cases of secondary trigeminal neuralgia in the region of the cerebellopontine angle, were treated with a small incision of the sigmoid sinus posterior approach to release trigeminal nerve decompression. Results: All the cases were cured by one operation and the physiological function of the trigeminal nerve was preserved. The follow-up ranged from 3 months to 3 years. The recent cure rate was 100%. No recurrence was found. Only partial cases had facial numbness Have done before the treatment of anhydrous alcohol, etc.). Twenty-one patients were found to have a responsible vessel during operation, and 106 patients underwent nerve compression, accounting for 94.6%. Conclusion: Vasodepressor cardiomyoplasty is an ideal surgical procedure for the treatment of trigeminal neuralgia. Application of cold light direct light source direct surgery, is responsible for the discovery of responsible vessels. Treatment of rock vein can improve the success rate of surgery. Responsible vascular compression of the trigeminal nerve is rooted into the sensitive area of ​​blood vessels