显微镜下锁孔入路舌咽神经根切断治疗舌咽神经痛的临床研究(1)
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[摘要] 目的 探讨显微镜下锁孔入路舌咽神经根切断治疗舌咽神经痛的临床疗效。方法 将60例舌咽神经痛患者，分为耳后枕下弧形切口，锁孔入路，显微镜下舌咽神经切断治疗组(A)和传统枕下乙状窦后入路直视下或带灯照明下舌咽神经切断对照组(B)。比较两组治愈率，复发率，手术切口，骨窗直径及并发症情况。结果 两组治愈率100%，随访3年复发率0，两组手术切口、骨窗直径及呛咳发生率比较具有显著统计学意义(P <0.05)；治愈率，随访3年复发率及呕吐、咽部感觉异常发生率两组间无统计学意义(P>0.05)。结论 显微镜下锁孔入路舌咽神经切断术治疗舌咽神经痛能够使手术精细、准确，减少创伤和并发症，是一种安全有效的手术方法。
[关键词] 锁孔入路； 舌咽神经痛； 舌咽神
The Clinical Research of Glossopharyngeal Neurectomy Treatment of Glossopharyngeal Neuralgia Under
the Microscope With Keyhole Approach
Zheng Guangming Li Gejun Zhang Shengxu
(The Affiliated People's Hospital of Henan University Neurosurgery,Henan,Kaifeng,475000)
[Abstract] Objective To explore the clinical curative effect of glossopharyngeal neurectomy treatment of glossopharyngeal neuralgia under the microscope with keyhole approach. Methods 60 cases of glossopharyngeal neuralgia were divided into treatment and control groups. The treatment group：Under the microscope surgery , keyhole approach, suboccipital Curved incision behind the ear , Glossopharyngeal neurectomy；the control group：and traditional suboccipital retrosigmoid approach under euthyphoria or with light Glossopharyngeal neurectomy, Compared two groups of cure rate, recurrence rate, surgical incision, bone window in diameter and complications. Results There was 100% cure rate, r recurrence rate was 0 after follow-up 3-year, two surgical incisions, bone window diameter and the incidence of cough had statistically significant difference between the two groups; the cure rate, relapse rate after follow-up 3-year vomiting and the incidence of pharyngeal paraesthesia between the two groups was not significant difference (P> 0.05).Conclusion Glossopharyngeal neurectomy treatment of glossopharyngeal neuralgia under the microscope with keyhole approach can make surgical precision, accuracy, reduce trauma and complications, is a safe and effective method.
[Key words] Keyhole approach； Glossopharyngeal neuralgia； Glossopharyngeal neurectomy； Microsurgery operation
舌咽神经痛是一种少见的神经痛病例，占三叉神经痛的0.2-1.3%[1]，虽不危及生命，但严重影响患者的生活质量，严重者将导致患者自杀，目前治疗舌咽神经痛的有效方法是显微镜下舌咽神经切断手术。2005年1月-2010年3月我院在显微镜下锁孔入路舌咽神经根切断治疗舌咽神经痛33例 ......
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