Lou Wei-hua, Lu Wu-hao, Sun Hui-ru
Department of Otorhinolaryngology, First Affiliated Hospital of Zhengzhou University, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008 Nov;43(11):818-21.
To introduce a modified laterocervical approach for glossopharyngeal neurotomy to treat idiopathic glossopharyngeal neuralgia.
The clinical data, the operative technique, the operative effects and (the results of) follow-up of 12 patients were presented. Through reviewing pertinent literatures, the therapeutic advancement of glossopharyngeal neuralgia and the modified technique of laterocervical approach for glossopharyngeal neurotomy were discussed. New idea on operations, of which the use of insulation coverings when cauterizing the inferior ganglion of glossopharyngeal nerve and Jacobson nerve were brought. Homonymous superior laryngeal nerve was excised at the same time.
All patients (the cases) were followed-up for 3 months to 3 years with an median of 15 months. Among the 12 patients suffered from glossopharyngeal neuralgia, 11 patients were satisfied with the outcomes and remained disease free after surgical treatment. The remission rate of pain was 100.0%, complete remission rate of pain was 91.7%. Only a few patients had complications. Intraoperative leakage of cerebrospinal fluid was obstructed with gelatin sponge and pasted with mucilage in 1 case and no complication appeared in the convalescence stage. Postoperatively, facial palsy was found in 1 case which was self-cured after a week, postoperative voice depression in 1 case, and foreign body sensation in 2 cases.
Laterocervical approach for glossopharyngeal neurotomy is an available method to treat idiopathic glossopharyngeal neuralgia.
介绍一种改良的颈外侧入路舌咽神经切断术治疗特发性舌咽神经痛。
介绍12例患者的临床资料、手术技巧、手术效果及随访结果。通过复习相关文献,探讨舌咽神经痛的治疗进展及改良的颈外侧入路舌咽神经切断术技术。提出手术新思路,即在烧灼舌咽神经下神经节和鼓室神经时使用绝缘覆盖物。同时切除同侧喉上神经。
所有患者随访3个月至3年,中位随访时间为15个月。12例舌咽神经痛患者中,11例对手术效果满意,术后无疾病复发。疼痛缓解率为100.0%,疼痛完全缓解率为91.7%。仅少数患者出现并发症。1例术中脑脊液漏用明胶海绵堵塞并用黏液粘贴,恢复期无并发症出现。术后1例出现面神经麻痹,1周后自愈,1例出现术后声音低沉,2例出现异物感。
颈外侧入路舌咽神经切断术是治疗特发性舌咽神经痛的一种有效方法。