微血管减压术：当代最新进展。

Microvascular decompression: a contemporary update.

作者信息

Okon Inibehe Ime, Menon Sidharth Sunil, Osama Mahmoud, Aiman Maidan, Paleare Luis F Fabrini, Eliseo Don Lucero-Prisno, Shafqat Muhammad Danish, Ezeaku Chizowa Okwuchukwu, Ferreira Márcio Yuri, Razouqi Youssef, Kapsetaki Marianna, Saniel Jovy Dia Remolino, Panit Naneta M, Rao Asad Gul, Iqbal Umer, Otobo Daniel David, Alkhawaldeh Ibraheem M, Pereira Felipe Salvagni, Akbar Imad, Kasimieh Omar, Chaurasia Bipin

机构信息

Department of Research, Medical Research Circle (MedReC), Bukavu, DR, Congo.

University College London Medical School, 74 Huntley St, Bloomsbury, London, WC1E 6DE, UK.

出版信息

BMC Surg. 2025 Jan 11;25(1):20. doi: 10.1186/s12893-025-02762-7.

DOI:10.1186/s12893-025-02762-7

PMID:39794712

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11724535/

Abstract

BACKGROUND

Microvascular decompression (MVD) is the gold-standard surgical treatment for cranial nerve compression disorders, including trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN). This review synthesizes historical milestones, recent advances, and evolving techniques in MVD, with a primary focus on these conditions.

METHODS

A comprehensive literature review was conducted using databases such as PubMed, SpringerLink, Google Scholar, BioMed Central, Scopus, and ScienceDirect. Studies published between 1970 and 2024 were analyzed, emphasizing surgical techniques, clinical outcomes, and technological innovations in MVD. Articles addressing TN, HFS, GPN, and other cranial nerve disorders treated with MVD were selected for detailed evaluation.

RESULTS

MVD demonstrates high efficacy, with 80-90% of patients achieving immediate symptom relief. Nevertheless, 15-25% of patients experience symptom recurrence, though long-term outcomes remain favorable. Fully endoscopic MVD has shown potential for enhanced intraoperative visualization, particularly in complex anatomical regions; however, its impact on surgical precision and clinical outcomes is still under investigation. Moreover, innovations in visualization technologies, including three-dimensional exoscopic systems and artificial intelligence-assisted surgery, continue to improve procedural safety and outcomes. Despite these advancements, complications such as hearing loss (1-2%) and cerebrospinal fluid leakage (2-4%) persist, highlighting the need for continuous refinement of techniques.

CONCLUSIONS

MVD is evolving with the integration of cutting-edge technologies, resulting in improved clinical outcomes and reduced complication rates. Emerging innovations such as robotic-assisted MVD and gene therapies for cranial nerve disorders, including TN and GPN, promise even greater efficacy and precision. However, further research is necessary to standardize surgical protocols and address disparities in healthcare systems globally.

摘要

背景

微血管减压术（MVD）是治疗颅神经压迫性疾病的金标准手术方法，这些疾病包括三叉神经痛（TN）、面肌痉挛（HFS）和舌咽神经痛（GPN）。本综述综合了微血管减压术的历史里程碑、近期进展和不断发展的技术，主要聚焦于这些病症。

方法

使用PubMed、SpringerLink、谷歌学术、生物医学中心、Scopus和ScienceDirect等数据库进行了全面的文献综述。分析了1970年至2024年间发表的研究，重点关注微血管减压术的手术技术、临床结果和技术创新。选择了涉及三叉神经痛、面肌痉挛、舌咽神经痛以及其他采用微血管减压术治疗的颅神经疾病的文章进行详细评估。

结果

微血管减压术显示出高疗效，80%至90%的患者症状立即缓解。然而，15%至25%的患者症状会复发，不过长期结果仍然良好。全内镜微血管减压术已显示出在增强术中可视化方面的潜力，特别是在复杂的解剖区域；然而，其对手术精度和临床结果的影响仍在研究中。此外，可视化技术的创新，包括三维外视镜系统和人工智能辅助手术，不断提高手术安全性和结果。尽管有这些进展，诸如听力损失（1%至2%）和脑脊液漏（2%至4%）等并发症仍然存在，这突出了持续改进技术的必要性。