The Application Research Of Via-cerebellar-fissures Approach In Primary Trigeminal Neuragia Surgery

Objective:Evaluation of via-cerebellar-fissures approach in the application of trigeminal nerve microvascular decompression,to make more evidence and experience and guide clinical application.Methods:Select 167 cases of primary trigeminal neuralgia that accept the microvascular decompression during january 2012-december 2013 in neurosurgery.According to the exclusion and inclusion criteria,collect 53 cases that accept traditional retrosigmoid approach surgery(group A)and 61 cases that accept via-cerebellar-fissures approach surgery(group B),comparative analysis the exposure of trigeminal nerve root,petrosal vein blocking situation,removal of the petrosal vein,the compression area of responsible vessels,the type of responsible vessels,the postoperative complications,instant curative effect and the follow-up the curative effect of 12th month,24th month and 36th month after operation,and then statistical analysis.Results:A,B group has no statistical difference in general clinical data and pain division(P>0.05);A,B group has statistical difference in the exposure of trigeminal nerve root(P<0.05);A,B group has statistical difference in petrosal vein blocking situation(P<0.05);A,B group has statistical difference in removal of the petrosal vein(P<0.05);A,B group has no statistical difference in the compression area of responsible vessels(P>0.05);A,B group has no statistical difference in the type of responsible vessels(P>0.05);A,B group has statistical difference in the disturbance of consciousness(P<0.05);A,B group has no statistical difference in the other complications(P>0.05);A,B group has no statistical difference of the curative effect in the first day,12th months and 24th months,but B group has better curative effect than A in the 36th month.Conclusion:via-cerebellar-fissures approach can not only reduce the pull of the cerebellum,avoid the petrosal vein blocking,take advantage of natural anatomical gap fully to expose trigeminal nerve root,better to discovery and decompression of offending vessels,but also has less postoperative complications involving the removal of the petrosal vein and better long-term curative effect in microvascular decompression.