[1]朱贵东　赵振宇　门学忠　楚德国　孙希炎　李翠玲　于　峰　王锦琰.原发性舌咽神经痛的显微手术治疗（附33例分析）[J].中国临床神经外科杂志,2016,(02):76-78.[doi:10.13798/j.issn.1009-153X.2016.02.005]
　ZHU Gui-dong,ZHAO Zhen-yu,MEN Xue-zhong,et al.Microneurosurgery for glossopharyngeal neuralgia（report of 33 cases）[J].,2016,(02):76-78.[doi:10.13798/j.issn.1009-153X.2016.02.005]
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原发性舌咽神经痛的显微手术治疗（附33例分析）()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年02期
页码:
76-78
栏目:
论著
出版日期:
2016-02-25

文章信息/Info

Title:
Microneurosurgery for glossopharyngeal neuralgia（report of 33 cases）
文章编号:
1009-153X（2016）02-0076-03
作者:
朱贵东　赵振宇　门学忠　楚德国　孙希炎　李翠玲　于　峰　王锦琰
250031 济南，济南军区总医院神经外科（朱贵东、赵振宇、门学忠、楚德国、孙希炎、李翠玲、于　峰）；100101 北京，中国科学院心理健康重点实验室（王锦琰）
通讯作者：于　峰，E-mail：yufeng.yf@163.com
Author(s):
ZHU Gui-dong1;  ZHAO Zhen-yu1;  MEN Xue-zhong1;  CHU De-guo1;  SUN Xi-yan1;  LI Cui-ling1;  YU Feng1;  WANG Jin-yan2.
Department of Neurosurgery, General Hospital of Jinan Command, PLA, Jinan 250031, China;
2. Key Laboratory of Mental Health, Institute of Psychology, CAS, Beijing 100101, China
关键词:
原发性舌咽神经痛; 显微手术; 枕下乙状窦后入路; 疗效
Keywords:
Glossopharyngeal neuralgia;  Microneurosurgery;  Complications
分类号:
R 745.1+3; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.02.005
文献标志码:
A
摘要:
目的 探讨显微手术治疗原发性舌咽神经痛的手术方式、手术疗效及长期随访结果。方法 2003年5月至2014年7月显微手术治疗原发性舌咽神经痛33例，手术均采用单侧枕下乙状窦后入路，微血管减压术23例，舌咽神经根及迷走神经根上部第1、2根丝切断术3例，微血管减压术+神经根切断术7例。所有患者术后随访10个月至11年，平均5.1年。结果 责任血管为椎动脉5例，为小脑后下动脉18例，为小脑后下动脉合并椎动脉8例，为小脑后下动脉合并小脑前下动脉1例；1例未发现责任血管。33例患者术后即刻疼痛全部消失。5例术后出现暂时性吞咽困难、饮水呛咳、声嘶，3例有阵发性干咳，l例有耳鸣，1例有复视；随访期间，除复视1例外，余9例患者并发症逐渐减轻至消失。结论 显微手术治疗舌咽神经痛是有效、安全的，正确合理选择适宜的术式，在保证疗效的前提下，术后并发症是可控、可接受的。
Abstract:
Objective To investigate the surgical method to treat glossopharyngeal neuralgia (GPN) and the effects of microsurgery on GPN. Methods The clinical data of 33 patients with GPN, who underwent microsurgery through retrosigmoid key hole approach from May, 2003 to July, 2014, were analyzed retrospectively. Of 33 patients followed up from 10 months to 11 years (mean, 5.1 years), 23 received microvasular decompression (MVD), 3 rhizotomy of glossopharyngeal nerve root and upper 1~2 rootlets of vagal nerve root and 7 MVD and the rhizotomy. Results The vessels responsible for GPN were vertebral artery (VA) in 5 patients, posterior inferior cerebellar artery (PICA) in 18, VA and PICA in 8, PICA and anterior inferior cerebellar artery (AICA) in 1. The responsible vessel was not found in 1 patient. GPN disappeared immediately after the operation in all the patients. The postoperative complications included dysphagia, choking and hoarseness in 5 patients, paroxysmal dry cough in 3, tinnitus in 1, and diplopia in 1. During the following-up period, the complications disappear gradually in 9 patients and there was still diplopia in 1 patient. Conclusions Microneurosurgery for GPN is effective and safe. Based on the correct and suitable operation, the postoperative complications can be controlled and acceptable..

参考文献/References:

[1] WH. Persistent pain in lesions of the peripheral and central nervous system [J]. Br Med J, 1921, 2(3178): 896-900.
[2] Blumenfeld A, Nikolskaya G. Glossopharyngeal neuralgia [J]. Curr Pain Headache Rep, 2013, 17(7): 343.
[3] Mccarron MO, Bone I. Glossopharyngeal neuralgia referred from a pontine lesion [J]. Cephalalgia, 1999, 19(2): 115- 117.
[4] Jannetta PJ. Observations on the etiology of trigeminal neu- ralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia: definitive microsurgical treat- ment and results in 117 patients [J]. Neurochirurgia (Stuttg), 1977, 20(5): 145-154.
[5] 宋　琴，权俊杰，屈建强，等. 显微血管减压术治疗舌咽神 经痛 23 例分析[J]. 临床神经外科杂志，2015，12（2）：96- 98.
[6] Taha JM, Jr Tew JM. Long-term results of surgical treat- ment of idiopathic neuralgias of the glossopharyngeal and vagal nerves [J]. Neurosurgery, 1995, 36(5): 926-931.
[7] Ferrante L, Artico M, Nardacci B, et al. Glossopharyngeal neuralgia with cardiac syncope [J]. Neurosurgery, 1995, 36 (1): 58-63.
[8] Kondo A. Follow-up results of using microvascular decom- pression for treatment of glossopharyngeal neuralgia [J]. J Neurosurg, 1998, 88(2): 221-225.
[9] Sampson JH, Grossi PM, Asaoka K, et al. Microvascular decompression for glossopharyngeal neuralgia: long-term effectiveness and complication avoidance [J]. Neurosurgery, 2004, 54(4): 884-890.
[10] 张奎启，王　福，仲维剑，等. 三叉神经痛、半面痉挛、舌咽 神经痛解剖学因素的研究[J]. 大连医科大学学报，2002， 24（1）：18-21.
[11] Patel A, Kassam A, Horowitz M, et al. Microvascular decompression in the management of glossopharyngeal neuralgia: analysis of 217 cases [J]. Neurosurgery, 2002, 50 (4): 705-711.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81400919）；中国科学院心理健康重点实验室经费资助（KLMH2014G01）
更新日期/Last Update: 2016-02-25