Surgical treatment of intermediate nerve neuralgia using intraoperative neurophysiological monitoring

V. S. Dementievskiy, E. A. Lekhnov, S. S. Baldina, G. N. Litvinchuk, D. Rzaev
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Abstract

Intermediate nerve neuralgia (INN) is a rare pathology with difficult diagnostics and currently there is no generally accepted surgical management protocol. In this regard, an optimal surgical strategy in this case is a difficult task. The aim was to determine an optimal approach for surgical management of patients with INN using intraoperative neurophysiological monitoring (IONM).The INN was diagnosed in a patient, a vestibulo‑cochlear complex dissection with intermediate nerve sectioning under IONM control of was performed intraoperatively. There was the earache regression, but there were gustatory disorders in the anterior portion on the left side of the tongue in the early postoperative period. In the late postoperative period, a delayed facial nerve paresis and signs of liquorrhea were diagnosed, which were completely regressed after reoperation and medication. The follow‑up period was more than 12 months; a stable regression of otoalgia was achieved. Intermediate nerve sectioning is an effective and common technique for the treatment of patients with INN. IONM improves surgical results and reduces a likelihood of different complications.
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利用术中神经电生理监测对中间神经痛进行手术治疗
中间神经痛(INN)是一种罕见的病症,诊断困难,目前还没有公认的手术治疗方案。因此,为这种病例制定最佳手术策略是一项艰巨的任务。我们的目的是利用术中神经电生理监测(IONM)确定 INN 患者手术治疗的最佳方法。一名患者被确诊为 INN,术中在 IONM 控制下进行了前庭-耳蜗复合体解剖和中间神经切断术。术后早期,耳痛消失,但左侧舌前区出现味觉障碍。术后晚期,患者出现迟发性面神经麻痹和腹泻症状,经过再次手术和药物治疗后,症状完全缓解。随访时间超过 12 个月,口痛稳定缓解。中间神经切断术是治疗 INN 患者的一种有效而常见的技术。中间神经切断术可改善手术效果,降低出现各种并发症的可能性。
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