Matsushima T, Inoue T, Fukui M
Department of Neurosurgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Surg Neurol. 1990 Aug;34(2):87-93. doi: 10.1016/0090-3019(90)90102-u.
The cisternal portion of the facial nerve and its contact arteries were examined anatomically in relation to neurovascular decompression surgery to treat hemifacial spasm. Thirty-five sides of brains from 20 autopsied adult patients were examined under a surgical microscope (x 5-x 25). One attaching point was found on 10 facial nerves, two points on 20 nerves, and three points on four nerves. More than two thirds of the facial nerves were attached at two points: the root exit zone and the distal cisternal portion. In a case of distal attachment, the contact artery formed an arterial-nerve complex with the distal portions of the facial and acoustic nerves. The arterial attachment at the root exit zone was evident on 24 of the 35 facial nerves (69%), and most of the contact arteries were the anterior inferior cerebellar artery and its branches. In five nerves, the root exit zone was attached at two points to arteries. The anatomy of autopsied brains without hemifacial spasm is not identical to that of actual clinical cases of hemifacial spasm; nevertheless, the results do aid in intraoperative anatomical orientations.
为了治疗面肌痉挛，对面神经脑池段及其接触动脉进行了解剖学研究，以用于神经血管减压手术。在手术显微镜（放大倍数为5倍至25倍）下检查了来自20例成年尸检患者的35侧大脑。在10条面神经上发现1个附着点，20条神经上发现2个附着点，4条神经上发现3个附着点。超过三分之二的面神经在两个点附着：神经根出脑区和脑池远端部分。在远端附着的病例中，接触动脉与面神经和听神经的远端部分形成动脉-神经复合体。35条面神经中有24条（69%）在神经根出脑区有明显的动脉附着，大多数接触动脉为小脑前下动脉及其分支。在5条神经中，神经根出脑区在两个点与动脉附着。无面肌痉挛的尸检大脑解剖结构与面肌痉挛实际临床病例的解剖结构并不相同；然而，这些结果确实有助于术中的解剖定位。
