【摘要】 <正> 酒精注射治疗三叉神经痛的疗效一般总是比不上手术治疗,但由于这一方法的簡便,經济負担不大,它在三叉神經痛的治疗領域中,还是有一定的价值。在酒精注射的疗效分析一文中,作者等曾指出了对这一疗法应采取的态度,及其合理的适应情况。遵照这些指針,多数患者在考虑作手术治疗以前,均曾在我院神經外科門診中接受过酒精注射。5年来我們曾经为128例患者作过226次酒精注射,但是更多还原

【Abstract】 Alcohol injection is one of the accepted methods of treatment for trigeminal neuralgia, but our results are not as favorable as claimed by others. In the hope of improving and standardizing the technic of injection we measured 520 adult skulls, paying special attention to the injection angle, the degree of axial variation, plane of inclination of foramen ovalc and the anatomical obstacles in the pathway of injection. Measurements for the anterior and lateral approaches were compared. The measurements obtained reveal that the lateral approach gives a slightly greater injection angle, 8.2° as compared with 7.5°, for the anterior approach. But the anterior approach has a more constant and lesser degree of axial deviation 13° as compared with 24.6°, for the lateral route. Correlating the injection anglo and degree of axial deviation, the estimated rate of success is greater for the anterior approach (0.58) than for the lateral approach (0.33). Anatomical obstacles in the pathways of injection may be encountered in both the anterior and lateral approaches. They may be (1) bony eminanee at the root of the external pterygoid plate, (2) bony spines in front of the foramen ovale, (3) bony ridge bridging over the foramen ovale or (4) protrusion of the inferior surface of the greater wing of sphenoid bone in front of the glenoid fossa of temporomandibular joint. In 76 out of 1,031 specimens (7.1％) the injection would be very difficult by the anterior route, and in 49 of 1,031 specimens (4.7％) the lateral approach would be difficult. Summing up these results, it seems logical to conclude that the anterior route of injection is slightly better than the lateral route. By reviewing the literature, it has been found that the results of injection claimed by some authors are better than what we can expect theoretically. The explanation, based on the experiments performed by Dr. Morris in 1931, is emphasized. Thus it is believed that strict requirement to puncture into the foramen ovale during alcohol injection is deemed unnecessary. Based on the measurements of 520 skulls a new angle of injection is suggested.更多还原