【摘要】 <正> 自1952年12月至1957年4月期中,我院共手术治疗了三叉神经痛病例53人,其中31例曾在我院或院外作过酒精注射,因无效或复发而接受手术治疗。手术的主要方法是三叉神经感觉根切断术,有4例作了周围枝的切断。我们没有作过sjoqvist氏的延脑三叉脊经切断术,亦未作过神经根的压迫或神经根半月节的减压手术。更多还原

【Abstract】 Fifty-three cases of major trigeminal neuralgia were treated by surgical operation during the period between Dec. 1952 to Apr. 1957 inclusively. Among these, 4 cases had peripheral branch resections, and 49 cases had retroganglionic rhizotomies of the trigeminal nerve. There were 2 postoperative deaths, an over all mortality of 3.8％. One of the 4 peripheral branch operations was found to be ineffective in relieving the pain, while in the 3 other cases pain recurred after about 2 years. Of the 49 cases of retroganglionic rhizotomies, there were 20 cases of Dahdy’s operation, 25 cases of Frazier’s operation and 4 cases of Wilkin’s operation. All, but one case of Dandy’s operation, were effective in relieving pain. Of the 2 deaths, one occurred after Dandy’s operation owing to secondary intracranial hemorrhage, the other, a Wilkin’s operation, died of an unknown cause. In comparing the postoperative complications, Dandy’s operation showed a higher incidence of cranial nerve injuries. Twenty five cases were followed up for two months to four and half years. It was found that one out of 13 cases after Frazier’s operation and 3 out of 6 cases after Dandy’s operation had slight recurrence of pain in the face of a much milder degree than prior to operation. There were 2 eases of cholesteatomas and one case of chronic arachnoiditis found during 20 Dandy’s operations. The tumors were removed completely at the same operation. Both had physical signs suggesting the presence of such a lesion before operation. Comparing the advantages and disadvantages of Frazier’s and Dandy’s operations we favor the former. It seems unjustified to subject every patient with genuine trigeminal neuralgia to a posterior fossa exploration which carries more risk than Frazier’s operation. Only when a lesion in the posterior fossa is suspected will Dandy’s operation be indicated. Our limited experience with Wilkin’s operation precludes us from commenting on it.更多还原