顔面痙攣および三叉神経痛に対する後頭蓋窩微小血管減圧術—手術手技上の工夫について

Posterior Fossa Microvascular Decompression for Hemifacial Spasm and Trigeminal Neuralgia:Some improvements on operative devices and technique

I．はじめに

　顔面痙攣および三叉神経痛に対して，微小血管減圧術が近年盛んに行われるようになり，その有効性は，すでに多くの施設から報告されている^1-3,6-8）．この手術は，いわば機能的手術であり，手術による合併症は最少限にとどめなければならない．

　われわれは，手術手技上，より安全かつ容易にできる方法につき検討を行い，特に，顔面痙攣についてその具体的な方法を紹介し，成績および合併症につき報告する．

Microvascular decompression has been widely used as a method for the treatment of hemifacial spasm and trigeminal neuralgia. We have experienced 30 such cases in the last 2 years; 25 of them were hemifacial spasm and 5 trigeminal neuralgia. Excel-lent results were obtained in 26 cases; the remaining two cases, both hemifacial spasm, were partially cured. Mild facial paresis appeared several days after the operation in 3 patients. In all the cases, the facial paresis recovered completely within several weeks. The cause of the facial paresis was not known.