Urculo E, Arrazola M, Gereka L, Olasagasti V, Olascoaga J, Urcola J, Zabalza R
Sección de Neurocirugía, Hospital de Guipúzcoa, Tolosa, España.
Rev Neurol. 1998 Sep;27(157):477-84.
The aim of the present study is to examine the operative technique and results of the treatment of trigeminal neuralgia (TN) by percutaneous microcompression of the trigeminal ganglion (Mullan's technique) in 20 consecutive patients over 3 years.
The average age of the patients was 63 years. There were 8 men and 12 women. The operative technique is similar to Mullan and Lichtor's original description with some modifications.
On average it takes 30 minutes to complete the procedure. On 2 occasions the catheter had to be replaced as the balloon burst without clinical repercussions. Detectable changes were noted in systemic blood pressure and cardiac rhythm in 10 cases. On 17 occasions the radiographic appearance of the balloon was pear-shaped and in the remaining cases it was oval or irregular. Follow-up ranged from 6 months to 3 years. All but 1 patient were initially relieved of pain and it was progressively possible to suspend treatment with carbamazepine. The recurrence rate was 25%. Mean time until recurrence was 18 months. There was no relation between pain location and recurrence. Morbidity: some degree of transient cheek discomfort, herpes simplex perioralis, hypesthesia and masseter weakness were the rule. Meningitis in one case.
Early results indicate that Mullan's technique provides a reliable, safe, cheap and effective, with low morbidity and no mortality.
本研究旨在探讨经皮三叉神经节微压迫术（穆兰技术）治疗三叉神经痛（TN）的手术技巧及疗效，研究对象为连续20例患者，为期3年。
患者平均年龄63岁，男性8例，女性12例。手术技巧与穆兰和利克托的原始描述相似，但有一些改进。
手术平均耗时30分钟。有2次因球囊破裂而更换导管，但未产生临床后果。10例患者出现全身血压和心律的可检测变化。17次球囊造影显示为梨形，其余病例为椭圆形或不规则形。随访时间为6个月至3年。除1例患者外，所有患者最初疼痛均得到缓解，且逐渐可以停用卡马西平。复发率为25%。平均复发时间为18个月。疼痛部位与复发之间无关联。发病率：常见一定程度的短暂面颊不适、唇周单纯疱疹、感觉减退和咬肌无力。1例发生脑膜炎。
早期结果表明，穆兰技术可靠、安全、廉价且有效，发病率低，无死亡率。
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