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[癌痛手术。本体小脑间隙中第九和第五神经切断术、安德施神经节和雅各布森神经切断术。适应症及结果]

[Surgery of cancer pain. Section of the IX and V nerves in the ontocerebellar space, section of Andersch's ganglion and Jacobson's verve. Indications and results].

作者信息

Gehanno P, Lallemant Y, Kosowski A

出版信息

Ann Otolaryngol Chir Cervicofac. 1975 Oct-Nov;92(10-11):573-84.

PMID:55089
Abstract

The authors describe their experience involving 30 patients treated surgically for stubborn algesia during the development of cancers of the face and neck. Sectioning Jacobson's nerve which they suggested for 72 cases exclusively or mainly involving otalgia especially where the tumours was tonsillar, proved of great therapeutic value and took little toll of the patients. - Resection of Andersch's ganglion, difficult and often ineffective, should not be attempted. - On the other hand, when there is stubborn pharyngeal pain with otalgia, sectioning the IXth is remarkably successful. Likewise, where there is pain in the face or tongue and the floor of the mouth which fails to respond to opiates, partial microcoagulation of the pre-pontile root of the trigeminal nerve is an excellent solution. - Neurotomies of the IXth and the Vth, carried out in the cerebellopontile angle, are operations with simple sequelae. They have the outstanding advantage of permanently relieving the pain of these unfortunate patients.

摘要

作者描述了他们对30例因头颈部癌症发展过程中顽固性疼痛而接受手术治疗患者的经验。他们建议对72例专门或主要涉及耳痛(尤其是肿瘤位于扁桃体处)的患者切断雅各布森神经,结果证明具有很大的治疗价值,且对患者造成的损害很小。 - 不应尝试切除安德施神经节,因为该手术难度大且往往无效。 - 另一方面,当存在伴有耳痛的顽固性咽痛时,切断第九脑神经非常成功。同样,当面部、舌头或口腔底部疼痛对阿片类药物无反应时,三叉神经脑桥前根部分微凝固是一个很好的解决办法。 - 在小脑脑桥角进行的第九脑神经和第五脑神经切断术,后遗症简单。它们具有永久缓解这些不幸患者疼痛的突出优点。

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