An Experimental Study Of Primary Trigeminal Neuralgia And Analysis Of The Therapeutic Effect Of Clinical Therapy

ObjectiveTo establish a model of chronic narrowing of the trigeminal neuralgia,simulate the clinical primary trigeminal neuralgia(PTN),observe the behavioral response of the SD rats to mechanical stimulation and histopathological changes of the trigeminal nerve The pathogenesis of primary trigeminal neuralgia and the search for new treatment methods provide the experimental basis.In clinical research,the clinical treatment of primary trigeminal neuralgia(PTN)by comparing microvascular decompression(MVD)with percutaneous balloon compression(PBC)Efficacy,designed to better guide the clinical,to provide patients with more effective personalized treatment.MethodsThe experiment is divided into basic experimental and clinical two parts,experiment one: Experimental study of primary trigeminal neuralgia;Experiment two: Microvascular decompression and percutaneous puncture micro-balloon compression for the treatment of primary trigeminal neuralgia Comparative Study.Experiment 1: The study was divided into two parts:(1)18 SD rats were randomly divided into experimental group(n = 9)and control group(n = 9).Experimental group SD rats were treated with two 4.0 wires The infraorbital nerve of the loosely cerclage rats further caused the model of chronic constriction injury.In the control group,the SD rats only exposed the infraorbital nerve under the same operating conditions,but did not receive cerclage.Observed and recorded the experimental group rats and the control group rats behavioral differences;(2)18 SD rats were randomly divided into experimental group(9)and control group(9),SD rats in the experimental group in microsurgery With the aid of a microscope,two 4.0swire loosen the cricoid loosening of the rat’s suborbital nerve and then cause a chronic constriction injury model.In the control group,the SD rats only exposed the infraorbital nerve in the same operating environment,but no cerclage.The differences of the experimental group at different histological levels and the control group were observed.Experiment 2: A retrospective analysis of 97 cases of primary trigeminal neuralgia treated in the Center for Treatment of Cerebral Nervous Diseases at the Armed Services Logistics Hospital Affiliated Hospital from October 2015 to November 2017 was reviewed.Among them,65 cases were treated with MVD and PBC(N = 32).The visual analogue scale(VAS)was used to observe the curative effect of the two surgical methods and the incidence of postoperative complications.Results1.Behavioral changes: SD rats in the experimental group showed hyperalgesia in the area dominated by the infraorbital nerve in the branch of the trigeminal nerve within a period of 1 to 5 weeks after operation.Statistical analysis by numerical comparison,the difference was statistically significant(P<0.05).2.Histological changes: HE staining of the infraorbital nerve showed that the swelling of the nerve fibers,the demyelination of the myelin,the destruction of the normal fiber structure occurred in the SD rats of the experimental group 1 week after the infraorbital nerve cerclage;3 weeks after surgery,HE staining showed that demyelination of nerve fibers still existed,and more severe;5 weeks after surgery,HE staining showed myelinated nerve fiber demyelination lesions,slightly better than before.3.The above 97 patients were followed up by phone and clinic,and statistical analysis was performed on the relevant data and values recorded.The cure rate and effective rate in the MVD treatment group were slightly higher than those in the PBC treatment group,but the difference was not statistically significant(P>0.05).Because the two surgical mechanisms are different,there are differences in postoperative complications between the two surgical groups.The postoperative complications of the MVD group were mainly low intracranial pressure syndrome.The postoperative complications of the PBC group were mainly facial sensory impairment and masticatory muscle weakness.ConclusionsAdult SD rat infraorbital nerve cerclage injury can cause the performance of trigeminal neuralgia.The behavioral changes of SD rats in experimental group were similar to the clinical manifestations of primary trigeminal neuralgia,and their behavioral responses were consistent with the local pathological changes.Further evidence of trigeminal demyelination and primary trigeminal neuralgia is closely related to the mechanism.MVD and PBC in the treatment of PTN has a good effect,the above two kinds of surgical procedures have their advantages and disadvantages.According to the different principles of the two operations,as far as PTN patients,as the first choice of MVD surgery,and PBC is mainly used in elderly patients or patients with contraindications craniotomy.