CAJ | 학술논문

目的探讨神经内镜在三叉神经微血管减压术中应用的可行性、手术技巧及注意事项。方法对北京世纪坛医院神经外科2008年12月至2010年12月21例原发性三叉神经痛患者在显微外科技术基础上，单纯应用神经内镜进行三叉神经微血管减压术。结果 21例中19例术后疼痛即消失，2例术后疼痛明显缓解，口服卡马西平1～3个月后疼痛逐渐消失，无三叉神经及其他颅神经损伤病例，无术后小脑肿胀及死亡病例。随访期间内无疼痛复发病例。结论神经内镜能够单独完成三叉神经微血管减压术，而且与显微手术相比具有局部解剖显露清晰，不易损伤神经、血管；不牵拉小脑半球，对正常脑组织损伤小等特点，值得临床推广。
목적 탐토신경내경재삼차신경미혈관감압술중응용적가행성、수술기교급주의사항。방법 대북경세기단의원신경외과2008년12월지2010년12월21례원발성삼차신경통환자재현미외과기술기출상，단순응용신경내경진행삼차신경미혈관감압술。결과 21례중19례술후동통즉소실，2례술후동통명현완해，구복잡마서평1～3개월후동통축점소실，무삼차신경급기타로신경손상병례，무술후소뇌종창급사망병례。수방기간내무동통복발병례。결론 신경내경능구단독완성삼차신경미혈관감압술，이차여현미수술상비구유국부해부현로청석，불역손상신경、혈관；불견랍소뇌반구，대정상뇌조직손상소등특점，치득림상추엄。
Objective To explore the feasibility, operating technique and precautions of endoscopic microvascular decompression for trigeminal neuralgia. Methods A retrospective analysis was conducted for 21 patients with primary trigeminal neuralgia. All underwent neuroendoscopic microvascular decompression for trigeminal nerves. Results The pains disappeared upon awaking post-anesthesia in 19 patients. In 2 patients, pains became significantly alleviated and disappeared after taking carbamazepine for 1 -3 months.No patient suffered the injuries of trigeminal nerve and other cranial nerves. None had cerebellum edema or death. During the follow-up period, there was no recurrence of pains. Conclusion Neuroendoscopic surgery may accomplish microvascular decompression for trigeminal nerve independently. As a minimally invasive and effective technique, it offers a clearer vision of local anatomy and decreases the probability of damaging nerves and vessels. There is no need for pulling cerebellum. It brings minimal damage to normal brain tissue compared with microsurgery. Further popularization is warranted.