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目的 :探讨减少乙状窦后径路桥小脑角手术并发症的发生并提高疗效的手术方法。方法 :对常规乙状窦后径路在皮肤切口、骨窗位置、颅内操作技术及硬脑膜缝合等方面进行了适当改进 ,并采用改良乙状窦后径路三叉神经感觉根部分切断术治疗三叉神经痛患者 5 4例。结果 :5 2例术后止痛效果良好 ,无并发症发生 ;2例术中未见三叉神经 ;随访 2～ 9年 ,复发 2例 ,为眶下神经痛 ,行眶下神经切断后疼痛消失。结论 :改良乙状窦后径路手术暴露桥小脑角较充分 ,操作更方便 ,并能减少颅内意外出血及并发症的发生。
Objective: To investigate the surgical methods to reduce the incidence of complications of cerebellopontine angle posterior approach of sigmoid sinus and improve the curative effect. Methods: The retrosiggated sigmoid sinus posterior approach was used to improve the incision of the skin, the position of the cranial bone, the technique of intracranial manipulation and the dural suture. The modified triosal sensory root excision was performed to treat the trigeminal nerve Pain in 54 cases. Results: Fifty-two cases of postoperative analgesia were effective and no complications occurred. Trigeminal nerve was not found in 2 cases and 2 cases were followed up for 2 to 9 years. 2 cases were infraorbital neuralgia and the pain disappeared after the orbital nerve was cut off. CONCLUSIONS: Modified posterior approach of the sigmoid sinus is more adequate for the exposure of the bridge of the cerebellopontine to the cerebellopontine. It is more convenient to operate and can reduce the incidence of intracranial accidental bleeding and complications.