Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm
Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm
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DOI：
10.1097/00006123-199701000-00009
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发表时间：
1997-01-01
期刊：
影响因子：
4.8
通讯作者：
Kondo, A
中科院分区：
文献类型：
--
作者：
Kondo, A
目的：本文对1976 ~ 1991年间行显微血管减压术治疗的1032例三叉神经痛（TN）和面肌痉挛（HFS）患者进行了5年以上的随访。早期系列，A组（1976-1986），包括588例患者（127例TN和461例HFS）随访10 - 20年（平均，12.6 +/- 2.1年），以及最近的系列，B组（1987-1991），包括444例患者（154例TN和290例HFS）随访5 - 9年结果：TN的术后即刻治愈率A组为92.9%，B组为96.7%，HFS的术后即刻治愈率A组为97.4%，B组为98.3%。随访结果：TN满意率A组为80.3%，B组为82.5%，HFS满意率A组为84.2%，B组为89.0%。TN的不完全治愈率A组为7.1%，B组为3.3%; HFS的不完全治愈率A组为2.6%，B组为1.7%。TN复发率A组为10.2%，B组为6.5%，HFS复发率A组为8.9%，B组为6.9%。术后听力障碍发生率：TN组7.1%，B组4.5%; HFS组9.1%，B组3.7%。结论：改善受累血管的复位方法和三叉神经轴的拉直方法是获得满意随访结果的重要因素。
OBJECTIVE: 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.METHOD: 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).RESULTS: 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.CONCLUSION: 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.