Fujii Takashi, Otani Naoki, Otsuka Yohei, Matsumoto Takashi, Tanoue Shunsuke, Ueno Hideaki, Tomura Satoshi, Tomiyama Arata, Toyooka Terushige, Wada Kojiro, Mori Kentaro
Department of Neurosurgery, National Defense Medical College.
No Shinkei Geka. 2017 Jun;45(6):503-508. doi: 10.11477/mf.1436203540.
A case of coexistent glossopharyngeal neuralgia and hemifacial spasm was treated by transposition of the vertebral artery. A 60-year-old man was referred to our hospital due to pain in the left posterior part of the tongue that was difficult to control with oral medication at a local hospital. The diagnosis was left glossopharyngeal neuralgia based on the symptoms, imaging findings, and lidocaine test results. Moreover, the patient had left hemifacial spasm. Microvascular decompression was performed, which confirmed that the vertebral artery was compressing the lower cranial nerve and the posterior inferior cerebellar artery was compressing the root exit zone of the facial nerve. The vertebral artery and posterior inferior cerebellar artery were transposed using TachoSil. After the surgery, both glossopharyngeal neuralgia and hemifacial spasm disappeared, and the patient was discharged.
一例舌咽神经痛与面肌痉挛并存的病例通过椎动脉转位术得到治疗。一名60岁男性因左侧舌后部疼痛在当地医院口服药物难以控制而转诊至我院。根据症状、影像学检查结果及利多卡因试验结果，诊断为左侧舌咽神经痛。此外，该患者还患有左侧面肌痉挛。进行了微血管减压术，证实椎动脉压迫下颅神经，小脑后下动脉压迫面神经根部出口区。使用速即纱对椎动脉和小脑后下动脉进行了转位。术后，舌咽神经痛和面肌痉挛均消失，患者出院。
