CAJ | 학술논문

目的探讨治疗不典型舌咽神经痛的有效手术方法.方法回顾性分析2007年1月至2013年4月治疗的13例不典型舌咽神经痛病例,总结其临床症状、术中所见、手术方法、疗效及随访结果,并结合文献进行分析.结果 9例存在血管压迫者行显微血管减压术联合舌咽神经根及迷走神经上部2～3根丝切断术.4例未见明确血管压迫者行舌咽神经根及迷走神经上部2～3根丝切断术.术后患者疼痛全部消失,并发症包括单纯吞咽困难1例、吞咽困难伴声音嘶哑1例、听力下降1例、偶发性干咳伴颅内感染1例.随访8个月～7年,并发症全部消失,随访期间无1例复发.结论对不典型舌咽神经痛采用显微血管减压术联合舌咽神经根及迷走神经上部2～3根丝切断术可获得优良疗效.
목적 탐토치료불전형설인신경통적유효수술방법.방법 회고성분석2007년1월지2013년4월치료적13례불전형설인신경통병례,총결기림상증상、술중소견、수술방법、료효급수방결과,병결합문헌진행분석.결과 9례존재혈관압박자행현미혈관감압술연합설인신경근급미주신경상부2～3근사절단술.4례미견명학혈관압박자행설인신경근급미주신경상부2～3근사절단술.술후환자동통전부소실,병발증포괄단순탄인곤난1례、탄인곤난반성음시아1례、은력하강1례、우발성간해반로내감염1례.수방8개월～7년,병발증전부소실,수방기간무1례복발.결론 대불전형설인신경통채용현미혈관감압술연합설인신경근급미주신경상부2～3근사절단술가획득우량료효.
Objective To investigate the effective surgical methods for the treatment of atypical glossopharyngeal neuralgia.Methods Thirteen patients with atypical glossopharyngeal neuralgia treated from January 2007 to April 2013 were analyzed retrospectively.The clinical symptoms,intraoperative findings,surgical methods,efficacy,and follow-up results of those patients were summarized and analyzed according to the literature.Results Nine patients with vascular compression were treated by the microvascular decompression in combination with rhizotomy of glossopharyngeal nerve root and vagal nerve upper 2 to 3 rootlets.Four patients without clearly vascular compression were treated by rhizotomy of glossopharyngeal nerve root and vagal nerve upper 2 to 3 rootlets.The postoperative pain of the patients disappeared completely.The complications included simple dysphagia (n =1),dysphagia with hoarseness (n =1),hearing loss (n =1),and occasional dry cough with intracranial infection (n =1).They were followed up for 8 months to 7 years.Their complications disappeared completely.No recurrence was observed during the follow-up period.Conclusion Atypical glossopharyngeal neuralgia treated by microvascular decompression in combination with rhizotomy of glossopharyngeal nerve root and vagal nerve upper 2 to 3 rootlets may obtain a good efficacy.