Neto Humberto Santo, Camilli José Angelo, Marques Maria Julia
Departamento de Anatomia, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), CP 6109, Campinas 13084-971, SP, Brazil.
Med Hypotheses. 2005;65(6):1179-82. doi: 10.1016/j.mehy.2005.06.012. Epub 2005 Aug 5.
Trigeminal neuralgia (TN) is the most important disease of the trigeminal nerve. Vascular compression of the dorsal root of the trigeminal nerve by aberrant loop of blood vessels is currently accepted as the most common cause of TN. The right side of the face is affected by TN twice as often as the left side, but there are no anatomical reasons for the blood vessels loop to be more frequent on the right side of the cranial fossa. Additionally, vascular compression in asymptomatic patients and in TN patients without aberrant blood vessels has been reported, thereby arguing against the idea that vascular compression alone is responsible for TN. Anatomical and radiological studies have shown that the rotundum and ovale foramens on the right side of the human cranium are significantly narrower than on the left side. The rotundum and ovale foramens are crossed by the maxillary and mandibular nerves, respectively, and are the nerves most affected in TN. Based on demographic and epidemiological data of TN patients, and on anatomical findings in the foramens, we hypothesized that entrapment of the maxillary and mandibular nerves when they cross the ovale and rotundum foramens is a primary cause of TN and accounts for the higher incidence of TN on the right sided.
三叉神经痛（TN）是三叉神经最重要的疾病。血管异常袢对三叉神经背根的压迫目前被认为是TN最常见的病因。面部右侧受TN影响的频率是左侧的两倍，但血管袢在颅窝右侧更频繁并无解剖学原因。此外，已有报道称无症状患者和无异常血管的TN患者存在血管压迫，因此反对仅血管压迫导致TN的观点。解剖学和放射学研究表明，人类颅骨右侧的圆孔和卵圆孔明显比左侧窄。上颌神经和下颌神经分别穿过圆孔和卵圆孔，且它们是TN中受影响最严重的神经。基于TN患者的人口统计学和流行病学数据以及孔道的解剖学发现，我们推测上颌神经和下颌神经在穿过卵圆孔和圆孔时受到卡压是TN的主要原因，并且解释了TN在右侧发病率较高的现象。
