Liu Pengfei, Liao Chenlong, Zhong Wenxiang, Yang Min, Li Shiting, Zhang Wenchuan
Department of Neurosurgery, XinHua Hospital, affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China.
J Craniofac Surg. 2017 May;28(3):e256-e258. doi: 10.1097/SCS.0000000000003481.
To investigate the characteristics of symptomatic trigeminal neuralgia (TN) caused by tumors and the relationship between anatomicosurgical findings and tumor type, the authors undertook a retrospective review of 35 patients with symptomatic TN between 2006 and 2015. The tumors included 16 meningiomas, 14 epidermoids, 4 vestibular schwannomas, and 1 hemangioblastoma. The studies show that patients with tumor-induced TN were significantly younger than those idiopathic TN (P <0.05). Meningioma-induced TN tended to have responsible vessels, while epidermoid tumor seemed to cause TN by wrapping or compressing the nerve. Additional vascular compression was observed in 15 (42.9%) of these 35 patients. All patients except one showed immediate pain relief following total or subtotal tumor removal with microvascular decompression (if required). Two patients with epidermoid-induced TN experienced symptom relapses caused by tumor regrowth, and one with meningioma-induced TN experienced pain recurrence caused by adhesive arachnoid. The key for operative success is to examine the entire nerve root for possible vascular compression after total or subtotal tumor resection.
为了研究肿瘤引起的症状性三叉神经痛（TN）的特征以及解剖手术结果与肿瘤类型之间的关系，作者对2006年至2015年间35例症状性TN患者进行了回顾性研究。肿瘤包括16例脑膜瘤、14例表皮样囊肿、4例前庭神经鞘瘤和1例血管母细胞瘤。研究表明，肿瘤诱发的TN患者比特发性TN患者明显年轻（P<0.05）。脑膜瘤诱发的TN往往有责任血管，而表皮样肿瘤似乎通过包裹或压迫神经导致TN。在这35例患者中，15例（42.9%）观察到额外的血管压迫。除1例患者外，所有患者在肿瘤全切或次全切并进行微血管减压（如需要）后疼痛立即缓解。2例表皮样囊肿诱发的TN患者因肿瘤复发出现症状复发，1例脑膜瘤诱发的TN患者因蛛网膜粘连出现疼痛复发。手术成功的关键是在肿瘤全切或次全切后检查整个神经根是否存在可能的血管压迫。
