摘要
目的 探讨神经内镜辅助锁孔微血管减压术治疗面肌痉挛的价值。方法 回顾性分析南京医科大学附属无锡二院神经外科自2007年1月至2011年6月收治的35例应用神经内镜辅助锁孔微血管减压术治疗的面肌痉挛患者的临床资料、手术资料及随访结果。手术方式为经枕下乙状窦后入路，并在垫人隔片前后均置入30°神经内镜行多角度的观察面神经全程及其周围血管，判别责任血管，并观察确认垫片位置，辅助垫片调整。28例在显微镜下行微血管减压术，7例在内镜下手术操作。结果 35例面肌痉挛患者，术后32例（91．4％）症状完全消失，2例（5．7％）明显缓解，1例（2．9％）无明显改善，总有效率97．1％。治疗有效的34例均获随访，随访时间6～60个月，平均30个月。1例术后第16个月复发，复发率2．9％。6例经神经内镜探查判定责任动脉，5例内镜探查后调整隔片位置。结论 神经内镜探查能避免遗漏责任血管、辅助调整隔片位置，能提高手术有效性，降低术后复发率。
Objective To explore the value ofneuroendoscopy assisted keyhole microvascular decompression （MVD） for treatment of patients with hemifacial spasm （HFS）. Methods The clinical data, operative data and follow-up results of 35 patients with HFS, admitted to our hospital from January 2007 to June 2011 and underwent neuroendoscopy-assisted keyhole MVD, were retrospectively analyzed. By suboccipital retrosigmoid approach, the 30° neuroendoscope was applied to perform multi-angle exploration of the entire nerve, distinguish the responsible vessels, and confirm the location of Teflon before and after placing the Teflon. Twenty-eight patients were performed MVD under microscope, and 7 cases were performed surgery under endoscope. Results In 35 patients with HFS, the effective rate was 97.1%, with 91.4% （32/35） being completely cured and 5.7% （2/35） being significantly relieved and one being unaffected. Follow-up was performed in these 34 successful cases for an average of 30 months （6-60 months）. One patient recurred 16 months after operation with an recurrence rate of 2.9%. Six patients were determined the responsible vessels by endoscope. Correcting Teflon was executed in 5 patients after endoscope exploration. Concision Neuroendoscope can help avoid missing and distinguishing the responsible arteries accurately, assist to rectify the position of Teflon, enhance the effectiveness of MVD, and reduce the postoperative recurrence rate.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2012年第10期1063-1065,共3页
Chinese Journal of Neuromedicine
关键词
神经内镜
锁孔
微血管减压术
面肌痉挛
Neuroendoscope
Keyhole
Microvascular decompression
Facial spasm
