中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
3期
63-65
,共3页
舌咽神经痛%舌咽神经切断术
舌嚥神經痛%舌嚥神經切斷術
설인신경통%설인신경절단술
Glossopharyngeal neuralgia%Glossopharyngeal neurotomy
目的 探讨颈侧入路舌咽神经切断术的两种方式(颈侧切舌咽神经、喉上神经切除术与单纯性舌咽神经切除术)治疗原发性舌咽神经痛的疗效及差异.方法 回顾性对比分析12例颈侧入路舌咽神经、喉上切断术(以下简称“术式一”)和13例颈侧切入路单纯舌咽神经切断术(以下简称“术式二”)治疗原发性舌咽神经痛患者的临床资料、手术方法、手术效果以及随访结果.结果 “术式一”术后随访3个月～3年,随访中位时间为15个月.12例行颈侧入路舌咽神经切断术的原发性舌咽神经痛患者中,11例患者疼痛完全缓解,1例症状明显减轻,疼痛缓解率达100％,疼痛完全缓解率达91.7％.“术式二”术后随访4个月～4.5年,随访中位数为15个月.13例患者中有11例疼痛症状完全消失,1例术后3个月疼痛症状再次发作,术后4个月经喉上神经封闭治疗后疼痛症状完全消失;1例术后症状再次出现,后行“开颅血管神经减压术”,术后未再复发.疼痛缓解率达92.3％,疼痛完全缓解率达84.6％.结论 颈侧切舌咽神经、喉上神经切除术与单纯性舌咽神经切除术两种手术方法均是治疗原发性舌咽神经痛的有效方法,且两者在治疗效果上不存在明显差异,术后并发症均轻微.在治疗原发性舌咽神经痛时,建议首选颈侧切单纯舌咽神经切断术,封闭或切断喉上神经可作为颈侧切入路单纯舌咽神经切断术效果不理想的补充.
目的 探討頸側入路舌嚥神經切斷術的兩種方式(頸側切舌嚥神經、喉上神經切除術與單純性舌嚥神經切除術)治療原髮性舌嚥神經痛的療效及差異.方法 迴顧性對比分析12例頸側入路舌嚥神經、喉上切斷術(以下簡稱“術式一”)和13例頸側切入路單純舌嚥神經切斷術(以下簡稱“術式二”)治療原髮性舌嚥神經痛患者的臨床資料、手術方法、手術效果以及隨訪結果.結果 “術式一”術後隨訪3箇月～3年,隨訪中位時間為15箇月.12例行頸側入路舌嚥神經切斷術的原髮性舌嚥神經痛患者中,11例患者疼痛完全緩解,1例癥狀明顯減輕,疼痛緩解率達100％,疼痛完全緩解率達91.7％.“術式二”術後隨訪4箇月～4.5年,隨訪中位數為15箇月.13例患者中有11例疼痛癥狀完全消失,1例術後3箇月疼痛癥狀再次髮作,術後4箇月經喉上神經封閉治療後疼痛癥狀完全消失;1例術後癥狀再次齣現,後行“開顱血管神經減壓術”,術後未再複髮.疼痛緩解率達92.3％,疼痛完全緩解率達84.6％.結論 頸側切舌嚥神經、喉上神經切除術與單純性舌嚥神經切除術兩種手術方法均是治療原髮性舌嚥神經痛的有效方法,且兩者在治療效果上不存在明顯差異,術後併髮癥均輕微.在治療原髮性舌嚥神經痛時,建議首選頸側切單純舌嚥神經切斷術,封閉或切斷喉上神經可作為頸側切入路單純舌嚥神經切斷術效果不理想的補充.
목적 탐토경측입로설인신경절단술적량충방식(경측절설인신경、후상신경절제술여단순성설인신경절제술)치료원발성설인신경통적료효급차이.방법 회고성대비분석12례경측입로설인신경、후상절단술(이하간칭“술식일”)화13례경측절입로단순설인신경절단술(이하간칭“술식이”)치료원발성설인신경통환자적림상자료、수술방법、수술효과이급수방결과.결과 “술식일”술후수방3개월～3년,수방중위시간위15개월.12례행경측입로설인신경절단술적원발성설인신경통환자중,11례환자동통완전완해,1례증상명현감경,동통완해솔체100％,동통완전완해솔체91.7％.“술식이”술후수방4개월～4.5년,수방중위수위15개월.13례환자중유11례동통증상완전소실,1례술후3개월동통증상재차발작,술후4개월경후상신경봉폐치료후동통증상완전소실;1례술후증상재차출현,후행“개로혈관신경감압술”,술후미재복발.동통완해솔체92.3％,동통완전완해솔체84.6％.결론 경측절설인신경、후상신경절제술여단순성설인신경절제술량충수술방법균시치료원발성설인신경통적유효방법,차량자재치료효과상불존재명현차이,술후병발증균경미.재치료원발성설인신경통시,건의수선경측절단순설인신경절단술,봉폐혹절단후상신경가작위경측절입로단순설인신경절단술효과불이상적보충.
Objective To investigate the effect and differences of lateral cervical approach glossopharyngeal nerve transection in two ways (lateral cervical glossopharyngeal neurotomy,superior laryngeal nerve resection with simple glossopharyngeal nerve resection) to treat idiopathic glossopharyngeal neuralgia.Methods The clinical data,surgical methods,surgical effect and follow-up results of 12 patients treated by glossopharyngeal nerve,laryngeal neurectomy through lateral cervical approach (hereinafter referred to as ‘surgical one'),and 13 patients treated by simple glossopharyngeal nerve transection through lateral cervical approach (hereinafter referred to as ‘ surgical two') were respectively analyzed.Results ‘ Surgical one':Patients were followed-up for 3 months to 3 years,and the median followed-up time was 15 months.Of the 12 patients,11 patients with complete pain relief,1 patient with ameliorated symptoms,the pain relief rate was 100％,and the pain completely relief rate was 91.7％.‘Surgical two':Patients were followed-up for 4 months to 4.5 years,and the median followed-up time was 15 months.Of the 13 patients,the pain disappeared completely in 11 cases,the pain recurrence at 3 months post-operatively in 1 case,and the pain disappeared completely after superior laryngeal nerve block at 4 months post-operatively.The symptoms recurred postoperatively in 1 case,no recurrence after neurovascular decompression craniotomy.Pain relief rate was 92.3％ and the pain completely relief rate was 84.6％.Conclusions Glossopharyngeal nerve,laryngeal neurectomy through lateral cervical approach and the simple glossopharyngeal neurotomy is the effective methods to treat idiopathic glossopharyngeal neuralgia,the effects have no significantly difference between the two groups,and the postoperative complications are minimal.In the treatment of primary glossopharyngeal neuralgia,glossopharyngeal neurotomy through lateral cervical approach is the preferred method,block or cut off the laryngeal nerve can be used as the complement of unsatisfied surgical result.
