Preliminary study of keyhole craniotomy for microvascular decompression in the treatment of vestibular paroxysmia

doi:10.3877/cma.j.issn.2095-9141.2023.01.008

Abstract

Abstract:

Objective

To investigate the efficacy of microvascular decompression (MVD) of vestibulocochlear nerve for treatment of vestibular paroxysmia (VP).

Methods

Ten patients admitted by Neurosurgery Department of Xuzhou Central Hospital from June 2016 to October 2022 were diagnosed as VP. MVD of vestibulocochlear nerve through retrosigmoid approach under general anesthesia was performed on those 10 patients, all of whom were followed up for 10-30 months to evaluate the treatment outcome.

Results

Microvascular compression of vestibulocochlear nerve was found in all 10 patients during operation. After operation, 5 patients were cured and 3 patients were improved, of which 2 patients gradually relieved to disappear after 12 months of follow-up, 2 patients had no obvious improvement in postoperative symptoms, of which 1 patient improved after 20 months of follow-up. No adverse reactions were found in all patients.

Conclusion

Under the premise of strict sugical indications, vestibulocochlear neurovascular decompression can be a safe and effective choice for treating vestibular paroxysmal disease.

Key words: Vestibular paroxysmia, Microvascular decompression, Neurovascular compression

Yongnan Wang, Qihong Wang, Jie Yin, Chunying Ou. Preliminary study of keyhole craniotomy for microvascular decompression in the treatment of vestibular paroxysmia[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(01): 43-47.

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References 26

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病例	年龄（岁）	性别	伴随症状	NVCC	HIT	ORTH	AEP	CT	NVCC与前庭功能检查一致性
1	50	女	无	L/AICA	无异常	左自发眼震	无异常	右>左27%	一致
2	40	女	伴呕吐	L/AICA	无异常	无异常	无异常	无异常	前庭功能正常
3	50	男	无	R/AICA	右下降	右PN（+）	无异常	右>左43%	一致
4	67	男	伴呕吐	L/AICA	无异常	右PN（+）	无异常	右>左35%	矛盾
5	60	男	伴耳鸣	L&R/PICA	无异常	右自发眼震	无异常	右>左50%	一致
6	55	男	伴耳鸣	L/VA	无异常	无异常	左侧异常	无异常	一致
7	67	女	无	R/V	无异常	无异常	无异常	无异常	前庭功能正常
8	68	男	无	R/AICA	无异常	无异常	左侧异常	右>左26%	矛盾
9	63	男	伴耳鸣	L&R/PICA	左下降	左PN（+）	无异常	无异常	一致
10	55	男	无	L/PICA	无异常	无异常	右侧异常	无异常	矛盾

病例	年龄（岁）	性别	伴随症状	NVCC	HIT	ORTH	AEP	CT	NVCC与前庭功能检查一致性
1	50	女	无	L/AICA	无异常	左自发眼震	无异常	右>左27%	一致
2	40	女	伴呕吐	L/AICA	无异常	无异常	无异常	无异常	前庭功能正常
3	50	男	无	R/AICA	右下降	右PN（+）	无异常	右>左43%	一致
4	67	男	伴呕吐	L/AICA	无异常	右PN（+）	无异常	右>左35%	矛盾
5	60	男	伴耳鸣	L&R/PICA	无异常	右自发眼震	无异常	右>左50%	一致
6	55	男	伴耳鸣	L/VA	无异常	无异常	左侧异常	无异常	一致
7	67	女	无	R/V	无异常	无异常	无异常	无异常	前庭功能正常
8	68	男	无	R/AICA	无异常	无异常	左侧异常	右>左26%	矛盾
9	63	男	伴耳鸣	L&R/PICA	左下降	左PN（+）	无异常	无异常	一致
10	55	男	无	L/PICA	无异常	无异常	右侧异常	无异常	矛盾

病例	术前VAS评分	术中所见	前庭功能	术后VAS评分	随访VAS评分	疗效评价
1	8分	AICA压迫伴蛛网膜增厚	好转	0分	0分	治愈
2	7分	AICA压迫	正常	7分	7分	无效
3	9分	AICA压迫伴蛛网膜增厚	好转	0分	0分	治愈
4	7分	AICA压迫	无改善	3分	3分	好转
5	7分	PICA压迫伴蛛网膜增厚	好转	0分	0分	治愈
6	8分	VA压迫伴蛛网膜增厚	好转	0分	0分	治愈
7	6分	V压迫	正常	6分	20个月后降为4分	好转
8	8分	AICA压迫伴蛛网膜增厚	好转	3分	10个月后降为0分	治愈
9	7分	PICA压迫	好转	0分	0分	治愈
10	8分	PICA压迫伴蛛网膜增厚	无改善	2分	12个月后降为0分	治愈

病例	术前VAS评分	术中所见	前庭功能	术后VAS评分	随访VAS评分	疗效评价
1	8分	AICA压迫伴蛛网膜增厚	好转	0分	0分	治愈
2	7分	AICA压迫	正常	7分	7分	无效
3	9分	AICA压迫伴蛛网膜增厚	好转	0分	0分	治愈
4	7分	AICA压迫	无改善	3分	3分	好转
5	7分	PICA压迫伴蛛网膜增厚	好转	0分	0分	治愈
6	8分	VA压迫伴蛛网膜增厚	好转	0分	0分	治愈
7	6分	V压迫	正常	6分	20个月后降为4分	好转
8	8分	AICA压迫伴蛛网膜增厚	好转	3分	10个月后降为0分	治愈
9	7分	PICA压迫	好转	0分	0分	治愈
10	8分	PICA压迫伴蛛网膜增厚	无改善	2分	12个月后降为0分	治愈

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