Zhang Wenhao, Chen Minjie, Zhang Weijie, Chai Ying
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi-zao-ju Road, Shanghai 200011, China.
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi-zao-ju Road, Shanghai 200011, China.
J Craniomaxillofac Surg. 2014 Jul;42(5):e182-5. doi: 10.1016/j.jcms.2013.08.004. Epub 2013 Sep 13.
The aim of this study was to evaluate the effects of electrophysiological monitoring on selective rhizotomy of the glossopharyngeal nerve (SRGN) in treatment of glossopharyngeal neuralgia (GPN). From December, 2009 to May, 2012, SRGN was carried out on 8 patients with GPN, through a suboccipital sigmoid sinus posterior approach. The electrodes were placed on the cricothyroid muscle (vagus nerve). Two groups of amplitudes (A1 and A2) were recorded. A1 was recorded when the mixed nerve root was stimulated, and A2 when the part of the vagus nerve was stimulated. The glossopharyngeal nerve was sectioned and the vagus nerve was preserved. If A1/A2 < 50%, the mixed nerve root should be sectioned, otherwise the mixed nerve root should be retained. As the representation of vagus nerve, the averages of A1 and A2 were 22 and 36 μV respectively. The 8 patients were followed up for 9-39 months. Seven patients (87.5%) obtained complete pain relief (excellent) without complications such as hoarseness, dysphagia, and cough. One case (12.5%) obtained moderate relief (good), and was under control with carbamazepine at a dosage of 600 mg/d. Cough was occurred in this patient, but relieved in two months. Electrophysiological monitoring in SRGN can improve the efficiency of pain relief and reduce the incidence of complications.
本研究旨在评估电生理监测在舌咽神经选择性切断术（SRGN）治疗舌咽神经痛（GPN）中的作用。2009年12月至2012年5月，对8例GPN患者采用枕下乙状窦后入路行SRGN。电极置于环甲肌（迷走神经）上。记录两组波幅（A1和A2）。刺激混合神经根时记录A1，刺激迷走神经部分时记录A2。切断舌咽神经并保留迷走神经。若A1/A2 < 50%，则切断混合神经根，否则保留混合神经根。作为迷走神经的表现，A1和A2的平均值分别为22和36 μV。对8例患者进行了9至39个月的随访。7例患者（87.5%）疼痛完全缓解（优），无声音嘶哑、吞咽困难及咳嗽等并发症。1例患者（12.5%）疼痛中度缓解（良），服用卡马西平600 mg/d可控制症状。该患者出现咳嗽，但2个月后缓解。SRGN中的电生理监测可提高疼痛缓解效率并降低并发症发生率。
