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目的:初步探讨眶下管减压术治疗三叉神经痛的临床疗效。方法:对2004-08/2007-08辽宁省鞍山市铁东区口腔医院收治的三叉神经痛第二支患者9例在局麻下经口内上颌前庭沟处切开,向上剥离黏骨膜,显露眶下孔和眶下神经,直视下用骨凿去除眶下管下壁,直至眶下沟,松解梳理眶下神经。治疗后平均随访22(6~40)个月,记录患者麻木、疼痛等相关情况。结果:术后疼痛均大幅缓解或消失,同时伴有眶下区、上唇的不同程度麻木。术后1~3个月随着麻木的消失,4例患者疼痛复发,2例口服小剂量卡马西平可控制,2例无效。其余5例患者随访期内未见疼痛复发迹象。结论:三叉神经痛是一种顽固的疼痛性疾病,眶下神经管减压术能够对部分眶下神经痛患者起到积极的治疗作用。
Objective: To investigate the clinical efficacy of orbital decompression in the treatment of trigeminal neuralgia. Methods: Nine patients with the second trigeminal neuralgia admitted to Tiedong District Stomatological Hospital, Anshan City, Liaoning Province from August 2004 to August 2007 underwent open incision of the maxillary vestibular groove under local anesthesia. The mucoperiosteum was dissected upwards to expose the infraorbital Hole and infraorbital nerve, under direct vision with an osteotome to remove the inferior orbital wall, until the infraorbital groove, release combing infraorbital nerve. After treatment, the patients were followed up for an average of 22 (6 ~ 40) months. Numbness and pain were recorded. Results: Postoperative pain were significantly alleviated or disappeared, accompanied by suborbital area, upper lip of varying degrees of numbness. Pain disappeared in 4 patients with relapse of numbness 1 to 3 months after operation. Two patients were given carbamazepine orally and two were ineffective. The remaining 5 patients showed no signs of recurrence during the follow-up period. Conclusion: Trigeminal neuralgia is a stubborn painful disease. Infraorbital nerve decompression can play a positive therapeutic role in some patients with suborbital neuralgia.