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山东大学学报(医学版) ›› 2015, Vol. 53 ›› Issue (10): 55-57.doi: 10.6040/j.issn.1671-7554.0.2015.274

• 临床医学 • 上一篇    下一篇

神经内镜下乙状窦后锁孔入路微血管减压术治疗面肌痉挛

徐然, 马翔宇, 李卫国, 李超, 张鑫, 徐淑军, 李新钢   

  1. 山东大学齐鲁医院神经外科, 山东 济南 250012
  • 收稿日期:2015-03-16 出版日期:2015-10-10 发布日期:2015-10-10
  • 通讯作者: 徐淑军。E-mail:xu-shujunql@163.com;李新钢。E-mail:xgli-sdu@163.com E-mail:xu-shujunql@163.com;xgli-sdu@163.com

Neuroendoscopic microvascular decompression for hemifacial spasm through retrosigmoid key hole approach

XU Ran, MA Xiangyu, LI Weiguo, LI Chao, ZHANG Xin, XU Shujun, LI Xingang   

  1. Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2015-03-16 Online:2015-10-10 Published:2015-10-10

摘要: 目的 探讨神经内镜下乙状窦后锁孔入路微血管减压术治疗面肌痉挛的手术技巧。方法 根据患者的临床症状及药物控制情况筛选出31例面肌痉挛患者,对以上患者全部行神经内镜下乙状窦后锁孔入路微血管减压术。结果 31例患者中,面肌痉挛症状完全缓解者24例(27.4%),明显减轻者6例(19.4%),未缓解1例(3.2%),术后出现轻度面瘫3例(9.68%),听力下降2例(6.45%),头晕伴频繁恶心呕吐者1例(3.23%),术后发热2例(6.45%)。无术后出血及小脑挫伤病例,无脑脊液漏及刀口愈合不良病例。结论 神经内镜下乙状窦后锁孔入路微血管减压术治疗面肌痉挛是在充分掌握神经解剖及熟练应用神经内镜基础上,取得高效微创治疗效果的一种新手术方式。

关键词: 面肌痉挛, 神经内镜, 微血管减压, 乙状窦后锁孔入路

Abstract: Objective To explore the surgical techniques of neuroendoscopic microvascular decompression for hemifacial spasm through retrosigmoid key hole approach. Methods A total of 31 patients with hemifacial spasm were selected based on clinical symptoms and conditions after drug use. Then neuroendoscopic microvascular decompression through retrosigmoid key hole approach was performed. Results After surgery, pain disappeared in 24 (77.4%) and reduced in 6 patients (19.4%), while 1 patient (3.2%) showed no obvious amelioration. Postoperative complications included mild facial parelysis in 3 cases (9.68%), hearing loss in 2 cases (6.45%), headache with frequent nausea and vomiting in 1 case (3.23%), and fever in 2 cases (6.45%). No postoperative bleeding, cerebellum contusion, leakage of cerebrospinal fluid or blade poor healing were observed. Conclusion Neuroendoscopic microvascular decompression through retrosigmoid key hole approach is a novel, effective and minimally invasive way to treat hemifacial spasm.

Key words: Microvascular decompression, Neuroendoscopic, Retrosigmoid key hole approach, Hemifacial spasm

中图分类号: 

  • R616.2
[1] Cheng WY, Chao SC, Shen CC, et al. Endoscopic microvascular decompression of the hemifacial spasm[J]. Surg Neurol, 2008, 70(Suppl 1): 40-46.
[2] Sindou M, Keravel Y. Neurosurgical treatment of primary hemifacial spasm with microvascular decompression[J]. Neurochirurgie, 2009, 55(2): 236-247.
[3] Cohen-Gadol AA. Microvascular decompression surgery for trigeminal neuralgia and hemifacial spasm: naunces of the technique based on experiences with 100 patients and review of the literature[J]. Clin Neurol Neurosurg, 2011, 113(10): 844-853.
[4] Zhong J, Li ST, Zhu J, et al. Is entire nerve root decompression necessary for hemifacial spasm?[J]. Int J Surg, 2011, 9(3): 254-257.
[5] Halpern CH, Lang SS, Lee JY. Fully endoscopic microvascular decompression: our early experience[J]. Minimally Invasive Surgery, 2013, 2013: 739432. doi: 10.1155/2013/739432.
[6] Kawashima M, Yamada M, Sato S, et al. Hemifacial spasm caused by vascular compression of the distal portion of the facial nerve associated with configuration variation of the facial and vestibulocochlear nerve complex[J]. Turkish Neurosurgery, 2009, 19(3): 269-275.
[7] Xia L, Zhong J, Zhu J, et al. Delayed relief of hemifacial spasm after microvascular decompression[J]. J Craniofac Surg, 2015, 26(2): 408-410.
[8] Jo KW, Kong DS, Park K. Microvascular decompression for hemifacial spasm: long-term outcome and prognostic factors, with emphasis on delayed cure[J]. Neurosurg Rev, 2013, 36(2): 297-301.
[9] 任杰, 袁越, 张黎, 等. 面神经远端血管压迫对面肌痉挛手术疗效的影响[J]. 中华神经外科杂志, 2011, 1(27): 48-51.REN Jie,YUAN Yue, ZHANG Li, et al. Influence of distal portion compression of facial nerve in hemifacial spasm surgery[J]. Chinese Journal of Neurosurgery, 2011, 1(27): 48-51.
[10] Moller AR,Moller MB. Microvascular decompression operations[J]. Prog Brain Res, 2007, 166: 397-400.
[11] Ray DK, Bahgat D, McCartney S, et al. Surgical outcome and improvement in quality of life after microvascular decompression for hemifacial spasms: a case series assessment using a validated disease-specific scale[J]. Stereotact Funct Neurosurg, 2010, 88(6): 383-389.
[12] Lescanne E, FranPois P, Velut S. Cerebellopontine cistern: microanatomy applied to vestibular schwannomas[J]. Prog Neurol Surg, 2008, 21: 43-53.
[13] Tatagiba MS, Roser F, Hirt B, et al. The retrosigmoid endoscopic approach for cerebellopontine-angle tumors and microvascular decompression[J].World Neurosurg, 2014, 82(6 Suppl): S171-176.
[14] Saylam C, Ucerler H, Orhan M, et al. The relationship of the posterior inferior cerebellar artery to cranial nerves VII-XII[J]. Clin Anat, 2007, 20(8): 886-891.
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