Department of Otolaryngology, Beijing Hospital, National Center of Gerontology, Beijing, China.
Department of ENT, Yunnan Province Hospital of Traditional Chinese Medicine (First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine), Kunming, Yunnan Province, China.
Acta Otolaryngol. 2020 May;140(5):378-382. doi: 10.1080/00016489.2020.1723808. Epub 2020 Feb 18.
The pathophysiology and etiology of vestibular paroxysmia (VP) remains unclear, moreover, due to the lack of reliable diagnostic features for VP, the clinical diagnosis will be made mainly by exclusion. To evaluate the diagnostic value and curative effect of keyhole microvascular decompression with local anesthesia for VP. 54 patients with trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia underwent keyhole microvascular decompression with local anesthesia, twelve of whom were coexistent with VP. The evaluation of the vertigo after operation was performed with symptom report card for 12 patients with VP and the mean follow-up period was 116 months (range 114-118 months). The cochleovestibular neurovascular compression at the root zone of vestibular nerve was found in 12 patients with VP, of whom 11 patients had the neurovascular compressive vertigo induced intra-operatively and the vertigo disappeared postoperatively, moreover, one patient had no neurovascular compressive vertigo induced intra-operatively and the vertigo was not improved significantly after operation. Of 12 patients with VP during the mean 116-month follow-up, 11 patients had no recurrence of neurovascular compressive vertigo and the effective control rate of vertigo was 91.7%. Keyhole microvascular decompression with local anesthesia is not only an effective method for treating VP and controlling neurovascular compressive vertigo, but also has definite clinical significance in the diagnosis of VP.
前庭阵发症（VP）的病理生理学和病因尚不清楚，此外，由于缺乏可靠的 VP 诊断特征，临床诊断主要通过排除法进行。评估局部麻醉下锁孔微血管减压术治疗 VP 的诊断价值和疗效。54 例三叉神经痛、面肌痉挛和舌咽神经痛患者行局部麻醉下锁孔微血管减压术，其中 12 例合并 VP。对 12 例 VP 患者采用症状报告卡评估术后眩晕，并进行平均 116 个月（范围 114-118 个月）的随访。在 12 例 VP 患者中发现前庭神经根部的耳蜗血管神经压迫，其中 11 例患者术中出现神经血管压迫性眩晕，术后眩晕消失，1 例患者术中无神经血管压迫性眩晕，术后眩晕无明显改善。在 12 例 VP 患者的平均 116 个月随访中，11 例患者无神经血管压迫性眩晕复发，眩晕控制率为 91.7%。局部麻醉下锁孔微血管减压术不仅是治疗 VP 和控制神经血管压迫性眩晕的有效方法，而且对 VP 的诊断具有明确的临床意义。
