【摘要】 目的　报告桥小脑角神经根显微血管减压术和(或)选择性神经根切断术的并发症。方法　回顾性分析322例行Ⅴ、Ⅶ、Ⅸ颅神经根减压、梳理及选择性切断术患者的并发症。其中半面痉挛164例, 96例行单纯面神经梳理术, 68例行面神经梳理术+显微血管减压术;三叉神经感觉根减压及选择性切断术128例;舌咽神经根减压术及切断术30例。结果　322例接受手术的患者中,死亡2例( 0 .6% );中重度神经性聋21例( 6. 5% ),听力完全丧失3例( 0 .9% );脑脊液漏20例(6.2% )。结论　尽管显微血管减压术及神经根切断术是相当安全的手术,但仍可发生死亡及其他并发症。注重手术细节的处理对降低脑损伤及颅内出血的发生至关重要;尽量避免牵拉及触动耳蜗神经以及术中应用ABR监测可有效防止术后神经性聋的发生。更多还原

【Abstract】 Objective To report the serious complications of microvascular decompression and (or) selective neurectomy in cerebellopontine angle. Methods To review 322 cases of microvascular decompression and (or) facial nerve splitting, selective neurectomy for hemifacial spasm ,trigeminal neuralgia and glossopharyngeal neuralgia respectively. Among 322 cases, hemifacial spasm 164, which 96 underwent facial nerve splitting, 68 underwent microvascular decompression and facial nerve splitting. The selective neurectomy and neurectomy were performed in 128 cases of trigeminal neuralgia and 30 cases for glossopharyngeal neuralgia respectively. Results Of the serious complications 2 died (0.6%), The mild to severe hearing impairment occurred in 21 cases (6.5%), in which 3 cases presented total hearing loss(0.9%); Postoperative cerebellospinal leakage in 20 (6.2%). Conclusions It was demonstrated that,even though the microvascular decompression and /or neurectomy was a safe procedure for posterior neuropathy, mortal and serious complications might occur. It was essential to pay great attention to the entire decompression procedure in avoiding cerebellar injury. Using of intraoperative ABR and avoiding of impairment of the acoustic nerve might contribute to the prevention of the postoperative hearing loss.更多还原