中国耳鼻咽喉头颈外科
中國耳鼻嚥喉頭頸外科
중국이비인후두경외과
Chinese Archives of Otolaryngology-Head and Neck Surgery
2015年
11期
575-577
,共3页
刘芳%魏成忠%许鸾森%黄魏宁
劉芳%魏成忠%許鸞森%黃魏寧
류방%위성충%허란삼%황위저
眩晕%前庭耳蜗神经%颅神经%麻醉,局部%前庭阵发症%神经血管减压术
眩暈%前庭耳蝸神經%顱神經%痳醉,跼部%前庭陣髮癥%神經血管減壓術
현훈%전정이와신경%로신경%마취,국부%전정진발증%신경혈관감압술
Vertigo%Vestibulocochlear Nerve%Cranial Nerves%Anesthesia,Local%vestibular paroxysmia%neurovascular decompression
目的：探讨局部麻醉下锁孔入路颅神经血管减压术对前庭阵发症的诊断价值及疗效评估。方法40例三叉神经痛、面肌痉挛及舌咽神经痛患者中，8例合并前庭阵发症患者采用局麻下经乙状窦后锁孔入路探查听神经根血管压迫情况，并进行神经血管减压治疗。运用症状卡，评价术后眩晕情况，随访期为36～61个月。结果术中8例前庭阵发症患者前庭神经根部均可见责任血管压迫，7例患者可诱发血管压迫性眩晕，术后眩晕均消失；1例患者未诱发出血管压迫性眩晕，术后眩晕无明显改善。平均随访57个月，8例前庭阵发症患者中，7例前庭阵发症患者无血管压迫性眩晕复发，眩晕有效控制率为87.5%。结论局麻下听神经根血管减压术是治疗前庭阵发症、控制血管压迫性眩晕的有效治疗方法，同时该方法对明确诊断前庭阵发症也具有一定的临床意义。
目的：探討跼部痳醉下鎖孔入路顱神經血管減壓術對前庭陣髮癥的診斷價值及療效評估。方法40例三扠神經痛、麵肌痙攣及舌嚥神經痛患者中，8例閤併前庭陣髮癥患者採用跼痳下經乙狀竇後鎖孔入路探查聽神經根血管壓迫情況，併進行神經血管減壓治療。運用癥狀卡，評價術後眩暈情況，隨訪期為36～61箇月。結果術中8例前庭陣髮癥患者前庭神經根部均可見責任血管壓迫，7例患者可誘髮血管壓迫性眩暈，術後眩暈均消失；1例患者未誘髮齣血管壓迫性眩暈，術後眩暈無明顯改善。平均隨訪57箇月，8例前庭陣髮癥患者中，7例前庭陣髮癥患者無血管壓迫性眩暈複髮，眩暈有效控製率為87.5%。結論跼痳下聽神經根血管減壓術是治療前庭陣髮癥、控製血管壓迫性眩暈的有效治療方法，同時該方法對明確診斷前庭陣髮癥也具有一定的臨床意義。
목적：탐토국부마취하쇄공입로로신경혈관감압술대전정진발증적진단개치급료효평고。방법40례삼차신경통、면기경련급설인신경통환자중，8례합병전정진발증환자채용국마하경을상두후쇄공입로탐사은신경근혈관압박정황，병진행신경혈관감압치료。운용증상잡，평개술후현훈정황，수방기위36～61개월。결과술중8례전정진발증환자전정신경근부균가견책임혈관압박，7례환자가유발혈관압박성현훈，술후현훈균소실；1례환자미유발출혈관압박성현훈，술후현훈무명현개선。평균수방57개월，8례전정진발증환자중，7례전정진발증환자무혈관압박성현훈복발，현훈유효공제솔위87.5%。결론국마하은신경근혈관감압술시치료전정진발증、공제혈관압박성현훈적유효치료방법，동시해방법대명학진단전정진발증야구유일정적림상의의。
[ABSTRACT]OBJECTIVETo evaluate the diagnostic value and curative effect of keyhole neurovascular decompression with local anesthesia for vestibular paroxysmia.METHODSOf 40 patients with trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia, 8 of them combined with vestibular paroxysmia underwent keyhole neurovascular decompression under local anesthesia to explore the vascular compression of acoustic nerve root and have the neurovascular decompression. The evaluation of the vertigo after operation was performed with symptom report card. The patients were followed-up for 36 to 61 months. RESULTSThe vessels compressing the root zone of the vestibular nerve were found in 8 patients with vestibular paroxysmia, of whom 7 patients had the vascular compression vertigo induced during operation and the vertigo was disappeared after operation, moreover, one patient had no vascular compression vertigo induced during operation and the vertigo was not changed after operation. With the average follow-up of 57 months, of 8 patients with vestibular paroxysmia, 7 patients had no recurrence of the vertigo, and the effective control rate was 87.5%.CONCLUSION Local anesthesia keyhole neurovascular decompression was not only an effective way for treating vestibular paroxysmia and controlling the vertigo, but also had certain clinical significance in the diagnosis of vestibular paroxysmia.
