Microneurosurgery for the trigeminal neuralgia and hemifacial spasm and glosspharyngeal neuralgia with endoscopic / 临床耳鼻咽喉头颈外科杂志

ABSTRACT

OBJECTIVE@#Discussing the use of endoscopy in the operation of microvascular decompression of cranial nerves to treat trigeminal neuralgia (TN), hemifacial spasm (HFS), glosspharyngeal neuralgia (GN) and some tumors of the cerebellopontine angle (CPA).@*METHOD@#Since 2006, 973 cases (including 420 cases of TN, 487 cases of HFS, 66 cases of GN) had received the operation of nervous decompression by approach of postauricular suboccipital to the CPA. All cases who used the endoscopy and the material was described in detail.@*RESULT@#In 420 TN patients, 390 (92.9%) were found responsible blood vessels. Two (0.5%) were found no responsible blood vessels but arachnoid adhesion, 28 were found CPA tumor secondary trigeminal neuralgia. In 487 HFS patients, 486 were found responsible blood vessels. Between the vascular and trigeminal nerve, teflon was used to decompress and isolate the facial nerve. In 66 GN, the glossopharyngeal nerve were cut and vagus nerve were decompressed. The short-term cure rate was 100%. Cerebrospinal fluid rhinorrhea occurred in 3 cases, 1 case of cerebellar infarction, 2 patients of cerebellar hemorrhage, 2 cases of pneumatosis. All complications were cured at last. There were no deaths. All cases were followed-up for 1 to 5 years. Four cases of TN and 4 cases of HFS recurrent, and none of GN recurrence.@*CONCLUSION@#The microneurosurgery of nervous decompression endoscopy technology for the treatment of TN, HFS, GN and some tumors of the CPA is an ideally functional and etiotropic operation. It is helpful to detect the responsible blood vessel and to protect the brain tissue and nerve function with endoscope, which can improve the success rate of the operation and avoid the complications. This technology has clinical application value.