摘要
为进一步提高颅内面神经干梳理术治疗面肌痉挛的手术疗效，对１９９１～１９９４年亲自做的１１０例患者的手术记录和随访情况进行分析。术中发现蛛网膜肥厚、粘连２２例（２０．０％），无血管压迫３５例（３１．８％），有明显血管压迫６６例（６０．０％），较Ｊａｎｎｅｔｔ等报道血管压迫率达９５％以上者为低。其中血管穿行于Ⅶ、Ⅷ颅神经间者１６例，如采用显微血管减压术将十分困难或有一定危险。手术１００％有效；随访１～４年，复发６例（５．４％）与早期手术经验不足或因血管包绕影响梳理程度有关。现认为面神经梳理最少应在２０个层面以上，使术后面神经反应最小刺激阈达１０ｍＡ为度。
Anewsurgicalapproachforthetreatmentofhemifacialspasmwascarriedoutin110casesfrom1991～1994.Thenoveltyofthisnewprocedureliesinsplittingoffacialnervebymakingmultiplecutsalongthelongaxisofthenerve descriptivelyatypeof“combing”.Amongthesecas-es,arachnoidthickeningandadhesionoccurredin35casesthroughoutthevascularcourse,66casesshowedvascularcompression(60%).AsegmentofvesselcouldbeseenlyingbetweenⅦandⅧcra-nialnervesin16cases.Underthelatercircumstancestepstakenfordecompressionwouldbeeithertooriskyorimpossible.Postoperativelyalcasesgotmarkedimprovementortotaldisappearanceofsymptoms&signs.Folowupvarying1～4yearsshowedrecurrenceofsymptomsin6cases(5.4%).Thiswasexplanedinlightofinsuficientsplitting.Itmightbeduetolackofexperienceoronaccountofvascularenclosures.Itwassuggestedthatatleast20cutsshouldbemadeandtestedwithaminimumof10mAelectricstimulationtoachievegoodresult.
出处
《中华耳鼻咽喉科杂志》
CSCD
1996年第4期234-236,共3页
Chinese Journal of Otorhinolaryngology
