Analysis On Microvascular Decompression For Glossopharyngeal Neuralgia: 8 Cases

Objective To explore the etiology of patients with glossopharyngeal neuralgia,summarize the clinical manifestations of glossopharyngeal neuralgia.and define the diagnosis and differential diagnosis of glossopharyngeal neuralgia.To explore the treatment of glossopharyngeal neuralgia,and to avoid the postoperative complications of glossopharyngeal neuralgia.Methods(1)In 3 cases(6 sides),Simulated with surgical approach in adult corpse head specimen,Open the CPA area,Observed the CPA structure and glossopharyngeal nerve dissection under the eyes and under the microscope,Use the digital camera recorded.In 2 cases,the cerebellar hemisphere was resected and 1 case was not resected.Detailed observation of glossopharyngeal nerve walking and peripheral vascular structure,and the results were recorded by the same method.(2)Collection in March 2010 to June 2016 in Ningxia Medical university general hospital treated 8 cases of glossopharyngeal nerve pain patients,all patients in the preoperative examination such as 3 d-TOF-MRTA,in order to make clear the blood vessels of the CPA area and the cranial nerve(especially the glossopharyngeal nerve root)set of anatomic relationships,All patients were treated with microvascular decompression.Retrospective analysis the clinical manifestations of the patients,and the operation situation,the curative effect after operation,postoperative complications and adverse reactions of treatment.Results(1)To observe the three cadaveric specimens,the glossopharyngeal nerve originated from the medullary olivine,and walked on the lower part of the auditory nerve,above the vagus nerve,and through the jugular vein hole.The blood vessels around the glossopharyngeal nerve One case was vertebral artery,one was PICA and one was AICA.(2)All patients were treated with microvascular decompression.Patients were followed up 6 and24 months.1 case of difficulty in swallowing,voice hoarse,6 months follow-up symptoms disappear;1 case of paroxysmal pharynx ministry unwell merger has always been a dry cough;1 case of tinnitus symptoms,6 months follow-up symptoms disappear;1 case of cerebrospinal fluid leakage,3 months postoperation,the patients was hospitalized and the symptoms disappear;1 case symptoms of recurrence after 2 years,but was better than preoperation,oral medication can be controlled,no surgery again.Conclusion Microvascular decompression is a precise and effective way to treat glossopharyngeal neuralgia,It is necessary to avoid the postoperative complications of glossopharyngeal neurosurgery and we should pay attention to the treatment of postoperative complication.