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目的探讨老年人三叉神经痛显微神经外科手术的术式选择。方法回顾本科2000～2007年112例60岁以上老年三叉神经痛病例,分析手术方式、疗效及并发症。结果微血管减压手术(MVD)47例,有效45例,复发3例,面部麻木8例;三叉神经感觉根部分切断术(PR)34例,有效34例,无复发,面部麻木34例;微血管减压术+感觉根部分电凝处理31例,有效31例,无复发,面部麻木26例。结论治疗存在血管压迫的老年人三叉神经痛,可采取MVD后对三叉神经感觉根部分电凝,较单纯MVD可降低远期复发率,术后造成的面部麻木无三叉神经感觉根部分切断术典型。
Objective To investigate the surgical selection of the neurosurgery in the elderly with trigeminal neuralgia. Methods From 2000 to 2007, 112 cases of elderly patients with trigeminal neuralgia over the age of 60 were retrospectively analyzed. The operative methods, curative effects and complications were analyzed. Results Forty-seven cases were treated with microvascular decompression (MVD), 45 cases were effective, 3 cases were recurrence, 8 cases were facial numbness, 34 cases were sensory root excision (PR), 34 cases were effective, 34 cases had no recurrence and 34 cases facial numbness. Decompression + sensory root partial electrocoagulation treatment in 31 cases, effective in 31 cases, no recurrence, facial numbness in 26 cases. Conclusions The treatment of trigeminal neuralgia in elderly patients with vascular compression may take MVD to partially coagulate the sensory root of the trigeminal nerve. Compared with simple MVD, the long-term recurrence rate can be reduced. The facial numbness caused by postoperative operation is not typical of the trigeminal nerve root excision .