CAJ | 학술논문

目的探讨CT定位翼腭窝穿刺治疗上颌神经后上齿槽分支神经痛的可行性及临床疗效. 方法选择兰州军区乌鲁木齐总医院神经外科自2006年5月至2011年3月收治的上颌神经后上齿槽神经分支痛患者18例,采用颧弓下侧入路穿刺,CT平行于颅底的轴位薄层扫描,骨窗位确定穿刺针位于翼腭窝内后行射频热凝治疗；治疗温度为85℃,治疗时间60 s,可重复治疗1次,以达到麻木覆盖上齿槽神经分布区为佳. 结果除1例非典型三叉神经痛患者治疗无效外,余1 7例患者治疗均获成功.术后随访6～22个月,Heft-Parker视觉模拟量表评分显示优15例,良好2例.所有患者术中、术后均无明显并发症. 结论 CT引导下翼腭窝穿刺定位准确,操作安全可靠,穿刺成功率高,具有较高临床实用价值.
목적 탐토CT정위익악와천자치료상합신경후상치조분지신경통적가행성급림상료효. 방법 선택란주군구오로목제총의원신경외과자2006년5월지2011년3월수치적상합신경후상치조신경분지통환자18례,채용권궁하측입로천자,CT평행우로저적축위박층소묘,골창위학정천자침위우익악와내후행사빈열응치료；치료온도위85℃,치료시간60 s,가중복치료1차,이체도마목복개상치조신경분포구위가. 결과 제1례비전형삼차신경통환자치료무효외,여1 7례환자치료균획성공.술후수방6～22개월,Heft-Parker시각모의량표평분현시우15례,량호2례.소유환자술중、술후균무명현병발증. 결론 CT인도하익악와천자정위준학,조작안전가고,천자성공솔고,구유교고림상실용개치.
Objective To study the therapeutic effect of CT-guided puncture for accurate radiofrequency thermocoagulation through the pteroygopalatine fossa approach in the treatment of maxillary neuralgia. Methods From May 2005 to March 2011, 18 patients with maxillary neuralgia underwent CT-guided puncture through the pteroygopalatine fossa approach for accurate radiofrequency thermocoagulation. Axial CT scanning parallel to the middle cranial fossa base was conducted for the patients to define that the puncture needle was within the pteroygopalatine fossa before radiofrequency thermocoagulation being performed at 85℃ for 60 seconds. The thermocoagulation was repeated once until anesthesia covered the innervation area of the superior alveolar nerve. Results Follow-up,ranging from 6 to 22 months (mean,10 months),showed successful puncture in all patients.According to the Heft-Parker' visual analog scale, 15 cases (83.3％) were rated as excellent and 2 as good (11.1％).There were no intraoperative or postoperative major complications in the patients. Conclusions Since CT-guided puncture through the pteroygopalatine fossa approach can safely ensure accurate radiofrequency thermocoagulation for treatment of maxillary neuralgia, it has a high therapeutic efficacy for the patients.It is also a minimally invasive procedure that can be easily and safely performed in clinic.