Wang Ji, Yu Rui, Qu Chuncheng, Jiang Jun, Wang Chengwei, Meng Qinghu, Wei Shengcheng
Department of Neurosurgery, The Second Hospital of Shandong University, Jinan, China.
J Craniofac Surg. 2018 Nov;29(8):2192-2194. doi: 10.1097/SCS.0000000000004856.
To evaluate and compare the long-term efficacy and safety of microvascular decompression (MVD) and glossopharyngeal nerve roots rhizotomy (GNR) in the treatment of glossopharyngeal neuralgia (GN).
The data of 37 patients with glossopharyngeal neuralgia undergoing MVD alone and MVD + GNR from July 2004 to March 2017 were analyzed retrospectively. Among them, 22 were MVD alone and 15 were MVD + GNR. All patients underwent preoperative cocaine experiments to verify diagnoses, preoperative magnetic resonance imaging examinations to detect compressing vessels near the root entry zone of the glossopharyngeal nerve. Operation via retrosigmoid approach, keyhole craniotomy, and postoperative efficacy was followed up.
Efficacy: In the 22 patients with MVD alone, 19 patients were cured and 3 patients improved. In the 15 patients with MVD + GNR, 14 patients were cured and 1 patient improved. There was no significant difference between the 2 groups (χ test, P > 0.05).
Postoperative complications in MVD group: 2 patients had short-term hoarseness and drinking cough, 1 patient with cerebrospinal fluid leakage, 1 patient with intracranial infection, 1 patient with ipsilateral hearing loss, and no deaths; postoperative complications in MVD + GNR group: permanent hoarseness in 2 patients, short-term drinking cough and hoarseness in 4 patients, ipsilateral facial paralysis in 1 patient, 1 patient with cerebrospinal fluid leakage, no intracranial infection and death. The incidence of postoperative hoarseness and drinking cough in MVD + GNR group was higher than that in MVD group (χ test, P < 0.05).
The MVD alone was a safe and effective method for the treatment of primary glossopharyngeal neuralgia, the efficacy was equivalent to MVD + GNR, and had low incidence of hoarseness and drinking cough.
评估并比较微血管减压术（MVD）和舌咽神经根切断术（GNR）治疗舌咽神经痛（GN）的长期疗效和安全性。
回顾性分析2004年7月至2017年3月期间37例行单纯MVD及MVD+GNR治疗的舌咽神经痛患者的数据。其中，单纯MVD组22例，MVD+GNR组15例。所有患者术前行可卡因试验以明确诊断，术前行磁共振成像检查以检测舌咽神经根入区附近的压迫血管。采用乙状窦后入路、锁孔开颅手术，并对术后疗效进行随访。
疗效：单纯MVD组22例患者中，19例治愈，3例好转。MVD+GNR组15例患者中，14例治愈，1例好转。两组间差异无统计学意义（χ检验，P>0.05）。
MVD组术后并发症：2例患者出现短期声音嘶哑及饮水呛咳，1例脑脊液漏，1例颅内感染，1例同侧听力丧失，无死亡病例；MVD+GNR组术后并发症：2例永久性声音嘶哑，4例短期饮水呛咳及声音嘶哑，1例同侧面部瘫痪，1例脑脊液漏，无颅内感染及死亡病例。MVD+GNR组术后声音嘶哑及饮水呛咳的发生率高于MVD组（χ检验，P<0.05）。
单纯MVD是治疗原发性舌咽神经痛的一种安全有效的方法，其疗效与MVD+GNR相当，且声音嘶哑及饮水呛咳的发生率较低。
