Kondo A
Department of Neurosurgery, Kitano Medical Research Institute and Hospital, Osaka, Japan.
Neurosurgery. 1997 Jan;40(1):46-51; discussion 51-2. doi: 10.1097/00006123-199701000-00009.
We evaluated the follow-up results of microvascular decompression in 1032 patients with trigeminal neuralgia (TN) and hemifacial spasm (HFS), who underwent operations between 1976 and 1991 and were followed for more than 5 years.
Patients were divided into two groups, and their follow-up results were compared and studied. The early series, Group A (1976-1986), comprised 588 patients (127 with TN and 461 with HFS) followed from 10 to 20 years (mean, 12.6 +/- 2.1 yr), and the recent series, Group B (1987-1991), comprised 444 patients (154 with TN and 290 with HFS) followed from 5 to 9 years (mean, 7.0 +/- 1.4 yr).
The immediate postoperative cure rates were 92.9% in Group A and 96.7% in Group B for TN and 97.4% in Group A and 98.3% in Group B for HFS. Satisfactory results obtained by the follow-up study were 80.3% in Group A and 82.5% in Group B for TN and 84.2% in Group A and 89.0% in Group B for HFS. Incomplete cure rates were 7.1% in Group A and 3.3% in Group B for TN and 2.6% in Group A and 1.7% in Group B for HFS. Recurrence rates were 10.2% in Group A and 6.5% in Group B for TN and 8.9% in Group A and 6.9% in Group B for HFS. Postoperative hearing dysfunction occurred in 7.1% of patients with TN in Group A and 4.5% in Group B and 9.1% of patients with HFS in Group A and 3.7% in Group B.
Improved methods of repositioning the affected vessels and of straightening the axis of the trigeminal nerve are important to obtain satisfactory follow-up results after microvascular decompression.
我们评估了1976年至1991年间接受手术且随访时间超过5年的1032例三叉神经痛（TN）和面肌痉挛（HFS）患者微血管减压术的随访结果。
将患者分为两组，对其随访结果进行比较研究。早期组，A组（1976 - 1986年），包括588例患者（127例TN患者和461例HFS患者），随访10至20年（平均12.6±2.1年）；近期组，B组（1987 - 1991年），包括444例患者（154例TN患者和290例HFS患者），随访5至9年（平均7.0±1.4年）。
A组TN患者术后即刻治愈率为92.9%，B组为96.7%；A组HFS患者术后即刻治愈率为97.4%，B组为98.3%。随访研究获得的满意结果，A组TN患者为80.3%，B组为82.5%；A组HFS患者为84.2%，B组为89.0%。A组TN患者不完全治愈率为7.1%，B组为3.3%；A组HFS患者不完全治愈率为2.6%，B组为1.7%。A组TN患者复发率为10.2%，B组为6.5%；A组HFS患者复发率为8.9%，B组为6.9%。A组TN患者术后听力功能障碍发生率为7.1%，B组为4.5%；A组HFS患者术后听力功能障碍发生率为9.1%，B组为3.7%。
改进受影响血管重新定位及三叉神经轴矫正方法对于微血管减压术后获得满意的随访结果很重要。
