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首页> 外文期刊>Neurosurgery >Microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: three surgical approach variations: technical note.
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Microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: three surgical approach variations: technical note.

机译：微血管减压治疗三叉神经痛，面肌痉挛和舌咽神经痛：三种手术方法的变化：技术说明。

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OBJECTIVE: We have used three different approaches, namely, the infratentorial lateral supracerebellar approach, the lateral suboccipital infrafloccular approach, and the transcondylar fossa approach, for microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia, respectively. Each approach is a variation of the lateral suboccipital approach to the cerebellopontine angle (CPA); however, each has a different site of bony opening, a different surgical direction, and a different route along the cerebellar surface. METHODS: The infratentorial lateral supracerebellar approach is used to access the trigeminal nerve in the superior portion of the CPA through the lateral aspect of the cerebellar tentorial surface. The lateral suboccipital infrafloccular approach is directed through the inferior part of the cerebellar petrosal surface to reach the root exit zone of the facial nerve below the flocculus. The transcondylar fossa approach is used to access the glossopharyngeal nerve in the inferior portion of the CPA through the cerebellar suboccipital surface, after extradural removal of the jugular tubercle as necessary. RESULTS: In all three approaches, the cerebellar petrosal surface is never retracted transversely, that is, the cerebellar retraction is never directed parallel to the longitudinal axis of the VIIIth cranial nerve, dramatically reducing the risk of postoperative hearing loss. CONCLUSION: The greatest advantage of the differential selection of the surgical approach is increased ability to reach the destination in the CPA accurately, with minimal risk of postoperative cranial nerve palsy.
机译：目的：我们采用了三种不同的治疗方法，分别是ten下外侧上小脑入路，枕下外侧外侧入路和，突窝入路，分别用于微血管减压治疗三叉神经痛，半面部痉挛和舌咽神经痛。每种方法都是小脑桥脑角（CPA）的枕下外侧入路的一种变化。但是，每个骨头都有不同的骨开口部位，不同的手术方向以及沿着小脑表面的不同路径。方法：下腹外侧race上小脑入路用于通过小脑腱表面外侧进入CPA上半部的三叉神经。枕下外侧颞下入路是通过小脑小结节表面的下部到达小球下方的面神经的根部出口区域。必要时经硬膜外摘除颈突后，采用con突窝方法通过小脑枕下表面进入CPA下部分的舌咽神经。结果：在所有三种方法中，小脑的睑板表面都不会横向缩回，也就是说，小脑的缩回绝不会平行于第八颅神经的纵轴，从而大大降低了术后听力损失的风险。结论：差异选择手术方法的最大优势是可以提高准确到达CPA目的地的能力，并且术后颅神经麻痹的风险最小。

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