摘要目的:明确迷走神经根丝切断术及不同切断数量对迷走-舌咽神经痛(VGPN)的治疗效果和长期影响。方法:回顾性分析航空总医院神经外科自2008年6月至2019年3月收治的85例VGPN患者资料，根据手术过程中血管神经关系分别采用单纯舌咽神经切断术(26例)、舌咽神经联合迷走神经第1分支切断术(29例)及舌咽神经联合迷走神经上段多支切断术(30例)3种治疗方式进行治疗，分析比较3组患者的临床疗效及随访结果。结果:85例患者治疗均有效，其中治愈76例(89.4%)，缓解9例(10.6%)。3组患者治愈率差异有统计学意义( χ2=6.370， P=0.041)，其中舌咽神经联合迷走神经第1分支切断组、舌咽神经联合迷走神经上段多支切断组治愈率明显高于单纯舌咽神经切断组，差异有统计学意义( P<0.05)。85例患者中共有10例(11.8%)出现颅神经功能障碍症状，随访6个月后6例患者症状消失，4例患者症状改善但不明显(舌咽神经联合迷走神经第1分支切断组1例，舌咽神经联合迷走神经上段多支切断组3例)。 结论:舌咽神经联合迷走神经根丝切断术治疗VGPN效果优于单纯舌咽神经切断术。

abstractsObjective:To confirm the treatment effect of vagus nerve fiber cuts on vagal-glossopharyngeal neuralgia (VGPN) and its long-term prognoses.Methods:A retrospective analysis of clinical data of 85 VGPN patients admitted to our hospital from June 2008 to March 2019 was performed. They accepted simple glossopharyngeal nerve excision (Group A, n=26), excision of both glossopharyngeal nerve and vagal nerve of first rootlet (Group B, n=29), or excision of both glossopharyngeal nerve and vagus nerve of superior rootlets (Group C, n=30). The clinical efficacy and long-term follow-up of patients in the three groups were analyzed and compared. Results:All 85 patients were effective, including 76 (89.4%) were cured and 9 (10.6%) were relieved. The cure rates in these three groups were significantly different ( χ2=6.370, P=0.041): the cure rate in Group B and Group C was significantly higher than that in Group A ( P<0.05). A total of 10 patients (11.8%) developed symptoms of cranial nerve dysfunction; during the 6 months of follow-up, symptoms disappeared in 6 patients, and symptoms slightly improved in 4 patients (one from Group B, and 3 from Group C). Conclusion:Simple glossopharyngeal nerve excision and excision of glossopharyngeal nerve combined with vagus nerve rootlets can effectively treat VGPN, and the latter has better therapeutic effect than the former.