改良副神经切断术治疗胸锁乳突肌痉挛的应用解剖学分析.pdfVIP

A b stra c t care should be done to observe the long term effect[5_7]. R ecently, w ith the clinical app lication of various surgical operation s, such as the accessory nerves am putation operation, deep brain stim ulation^ , m icrovascular decom pression-9-, selective peripheral nerve am putation and m uscle exsection etc[10， 11]， they w ill bring hope to the treatm ent of Spasm odic Torticollis. A m ong all the operation s m ention ed above, th e accessory nerves am putation operation is m ost w idely used in curing the spasm odic torticollis, becau se the effect of w h ich is good and the cure rate is high . H ow ever, the disadvantages of the operation axe, the anatom ical structure of the neck is com p licated and the requ irem ent in perform in g the operation s is hard to m eet. W hen or after the accessory nerves am putation operation, com plication s alw ays happen becau se the op eration som etim es w ill cau se dam age of th e surroun ding structures. In our follow -up v isits of the patients w ho have the norm al accessory nerves am putation operation, w e found the follow ing three cases are quite com m on am ong the patients. 1 - D am aging the great auricu lar nerve, w h ich w ill cau se the skin sensory d isturbance of the great auricu lar nerve parts such as parotid gland, the low er part of m asseter m u scle，earlob e， auricle and m asto id ;2. C au sing the dysfunction of th e trapezius m uscles. A fter the accessory nerves w ere cut off, it w ill resu lt in the slop ing shou lders. 3. T he relap se of Spasm od ic Tortico llis shortly after the accessory nerves am putation operation . T herefore, w e w ill do the app lied anatom y stu dy on the adjacent structure of th e accessory nerves, and redesign th e surg ical app roach es an d resection scop e, so as to avoid the happen ing of the com p lication s. O bjectiv e : T