Li H Y, Xing Y Z, Lai S L, Wang L, Liang Q H
Department of Neurosurgery, Henan Provincial People's Hospital, Zhengzhou 450003, China.
Zhonghua Yi Xue Za Zhi. 2019 Jun 18;99(23):1805-1808. doi: 10.3760/cma.j.issn.0376-2491.2019.23.011.
To investigate the surgical nuances and efficacy of microvascular decompression in patients with coexistent hemifacial spasm and ipsilateral trigeminal neuralgia. Seventeen patients suffered from coexistent hemifacial spasm and ipsilateral trigeminal neuralgia were treated in Department of Neurosurgery, Henan Provincial People's Hospital from January 2008 to September 2017. The medical recorders, intra-operative findings and postoperative follow-up results of these patients were reviewed, and the surgical strategies and therapeutic effects of these patients were summarized. The offending vessels of the patients coexistent hemifacial spasm and ipsilateral trigeminal neuralgia were complex. The tortuous vertebral artery shifted to the suffered side in nine patients (52.9%), among which seven cases had vertebral artery as the offending vessel or indirect offending vessel compressing facial nerve and/or trigeminal nerve. The effective rate was 100%,the cure rate was 94.1%, and the immediate relief rate was 82.4%. All the patients were followed up for more than one year without recurrence. Patients with coexistent hemifacial spasm and ipsilateral trigeminal neuralgia with tortuous vertebral artery shifted to the affected side were more common. Good surgical nuances and strategies in microvascular decompression are the guarantee of successful surgery.
探讨微血管减压术治疗面肌痉挛合并同侧三叉神经痛患者的手术细节及疗效。回顾性分析2008年1月至2017年9月在河南省人民医院神经外科接受治疗的17例面肌痉挛合并同侧三叉神经痛患者的病历资料、术中所见及术后随访结果，总结手术策略及治疗效果。面肌痉挛合并同侧三叉神经痛患者的责任血管情况复杂。9例（52.9%）患者迂曲的椎动脉向患侧移位，其中7例以椎动脉作为责任血管或间接责任血管压迫面神经和/或三叉神经。有效率为100%，治愈率为94.1%，即刻缓解率为82.4%。所有患者均随访1年以上无复发。面肌痉挛合并同侧三叉神经痛且迂曲椎动脉向患侧移位的患者较为常见。微血管减压术中良好的手术细节及策略是手术成功的保证。
