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설인신경통 미세혈관 감압수술에서 피브린아교를 덧칠한 테플론 슬링을 사용한 원인 질환 치환술의 역할에 대한 고찰
- Alternative Title
- Kim, Young Im
- Author(s)
- Kim, Young Im
- Alternative Author(s)
- Kim, Young Im
- Advisor
- 안영환
- Department
- 일반대학원 의학과
- Publisher
- The Graduate School, Ajou University
- Publication Year
- 2014-02
- Language
- eng
- Alternative Abstract
- BACKGROUND CONTEXT: Glossopharyngeal neuralgia (GPN), caused by irritation of the glosspharyngeal nerve, can be devastating to the patient, with lancinating pain that can be triggered by simple daily actions such as chewing and swallowing that proper treatment is necessary. However, treatment of GPN is difficult, more medically intractable compared to other cranial rhizopathies that operation is often considered for cure. Microvascular decompression (MVD) in GPN patients are known to show fine outcome, but due to its rarity, not enough reports have been made to prove efficacy and safety of the MVD over other treatments. Recurrence after MVD have also been noted. PURPOSE: To evaluate the outcome of patients who underwent operation for MVD of GPN via new sling technique for better outcome, along with review of literatures. STUDY DESIGN: A retrospective study of patients who underwent same operation under the same diagnosis. METHODS: This single-institution retrospective analysis included 22 glossopharyngeal neuralgia patients who received MVD from 1996 to 2012. The operation was performed by a single experienced surgeon with retromastoid craniotomy via lateral suboccipital approach. Decompression method involved were transposition with glue for eight (36.4%) patients, transposition with sling for seven (31.8%) in those with very tortuous offenders, and interposition for those with many perforating vessels that made transposition impossible. RESULTS: Preoperative symptoms were relieved immediately after the operation in all patients, and no recurrence has occurred so far during the follow-ups. Postoperative complications occurred in 5 of the 22 patients, all transient, and there was no surgical mortality. CONCLUSION: Glossopharyngeal neuralgia can be safely and affectively treated by MVD, and adequate decompression of the offender is an important factor directly contributing to increased success rate of this surgery. Fibrin glue-coated Teflon sling can contribute to good outcome of the MVD operation by aiding in successful transposition of the offending vessels that may be too tortuous to be affectively decompressed by conventional techniques.
- Fulltext
- Appears in Collections:
- Graduate School of Ajou University > Department of Medicine > 3. Theses(Master)
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