Comprehensive comparison of surgical choice for glossopharyngeal neuralgia:A retrospective study of 205 cases

【作者】 张黎； 于炎冰； 申宇晓；

【机构】 中日友好医院神经外科；

【摘要】 OBJECTIVE:To investigate the immediate and long-term follow-up results of microvascular decompression(MVD) or MVD+ glossopharyngeal nerve rhizotomy(GNR) or MVD+GNR+ partial vagus nerve rhizotomy(VNR) for treating glossopharyngeal neuralgia(GN).METHODS:We retrospectively reviewed 205 patients diagnosed with GN who underwent surgeries in our hospital from January 2010 to January 2017.The patients were divided into 3 cohorts,that is,patients treated with MVD alone or MVD+GNR or MVD+GNR+VNR.RESULTS:There were similar results(MVD vs.MVD+GNR vs.MVD+GNR+VNR) in immediate pain relief rates(90.9% vs 91.3% vs 98%),short-term cranial nerve(CN) Ⅸ/Ⅹ related complication rates(13.6% vs 23.9% vs 28.6%),short-term CN Ⅶ/Ⅷ related complications rates(16.3% vs 15.2% vs 14.3%) and other complication rates(6.3% vs 8.7% vs 12.2%.Long-term follow-up was available in 130(63.4%) patients There were no significant statistical differences in long-term pain relief.However,in patients combined with TN,the pain relief rate was different between MVD group and two other groups(66.7% vs 95.2%,p<0.05).In addition,a great statistical difference was seen in long-term CN Ⅸ/Ⅹ related complications between MVD group and MVD+GNR group.The numbers of CN Ⅸ/Ⅹ related symptoms per patient was 2.31±0.99 in MVD+GNR+VNR group,which was higher than two other groups but without statistical difference.CONCLUSIONS:In general,this study indicates that MVD alone was efficient enough for most GN patients with probable mild complications but GNR and VNR still had its significance in some situations.We suggest to undergo nerve section for patients with coexistent GN and TN.GN might have subtypes and we hope the choice of treatment for GN can be more accurate in the future.更多还原

【Abstract】 OBJECTIVE:To investigate the immediate and long-term follow-up results of microvascular decompression(MVD) or MVD+ glossopharyngeal nerve rhizotomy(GNR) or MVD+GNR+ partial vagus nerve rhizotomy(VNR) for treating glossopharyngeal neuralgia(GN).METHODS:We retrospectively reviewed 205 patients diagnosed with GN who underwent surgeries in our hospital from January 2010 to January 2017.The patients were divided into 3 cohorts,that is,patients treated with MVD alone or MVD+GNR or MVD+GNR+VNR.RESULTS:There were similar results(MVD vs.MVD+GNR vs.MVD+GNR+VNR) in immediate pain relief rates(90.9% vs 91.3% vs 98%),short-term cranial nerve(CN) Ⅸ/Ⅹ related complication rates(13.6% vs 23.9% vs 28.6%),short-term CN Ⅶ/Ⅷ related complications rates(16.3% vs 15.2% vs 14.3%) and other complication rates(6.3% vs 8.7% vs 12.2%.Long-term follow-up was available in 130(63.4%) patients There were no significant statistical differences in long-term pain relief.However,in patients combined with TN,the pain relief rate was different between MVD group and two other groups(66.7% vs 95.2%,p<0.05).In addition,a great statistical difference was seen in long-term CN Ⅸ/Ⅹ related complications between MVD group and MVD+GNR group.The numbers of CN Ⅸ/Ⅹ related symptoms per patient was 2.31±0.99 in MVD+GNR+VNR group,which was higher than two other groups but without statistical difference.CONCLUSIONS:In general,this study indicates that MVD alone was efficient enough for most GN patients with probable mild complications but GNR and VNR still had its significance in some situations.We suggest to undergo nerve section for patients with coexistent GN and TN.GN might have subtypes and we hope the choice of treatment for GN can be more accurate in the future.更多还原