舌咽神経痛に対するmicrovascular decompression

Microvascular Decompression for Glossopharyngeal Neuralgia

Point

・痛みの部位を除けば，三叉神経痛に酷似している舌咽神経痛に，実は独自の臨床的特色があることを述べた．

・一般に，多くの手術経験を望めない舌咽神経痛の手術について安全，確実に完遂するためにポイントとなる点を強調した．

　Glossopharyngeal neuralgia is an extremely rare disease. Therefore, average neurosurgeons have limited number of opportunities for surgical experience of glossopharyngeal neuralgia.

　The authors mentioned several important surgical steps to achieve successful surgery.

　The initial cerebellar retraction should be modest to avoid unexpected rupture of bridging veins.

　The arachnoid between the lower cranial nerves and cerebellum should be fully dissected until the root entry/exit zones of all lower cranial nerves are easily observed.

　The offending arteries（especially the posterior inferior cerebellar artery）are tethered using arachnoid filaments.

　Complete dissection of the tethering arachnoid filaments is necessary for the offending artery to be mobilized and glued to the dural surface.