Objective: To study the operative method, special technique and curative effect of complete neuroendoscopic microvascular decompression(MVD) related to vertebrobasilar artery compression. Methods: Thirteen patients with functional cranial nerve disease caused by vertebrobasilar artery as direct or indirect responsible vessel accepted complete endoscopic MVD, including 11 patients with hemifacial spasm and 2 patients with trigeminal neuralgia. The procedure and curative effect of endoscopic surgery were analyzed retrospectively. Results: All procedures of complete neuroendoscopic MVD were successfully completed.Intraoperative observation by endoscope showed that 6 cases were oppressed directly by vertebral artery, 2 cases were oppressed directly by basilar artery, 5 cases were combined oppressed by displaced basilar artery and other vessels (1 case was superior cerebellar artery and 4 cases were anterior inferior cerebellar artery). During the operation, Teflon sheets was placed directly into the compression point in 2 cases, the "Pre-placed" technique was used to place Teflon sheets in 7 cases, and the "Set up bridge" technique was used to place Teflon sheets in 4 cases. Follow-up for 8-38 months,the symptoms disappeared completely in 12 cases and improved in 1 case. No deaths and severe complications occurred, such as postoperative bleeding, cerebellar infarction and intracranial infection. Conclusion: MVD related to vertebrobasilar artery compression can be performed by complete neuroendoscopic technique, which can achieve sufficient decompression effect and curative effect.Flexible use of the special technology of placing Teflon sheets by single-hand under endoscope, such as the "Pre-placed" and "Set up bridge" technique, is an important technical guarantee for the successful completion of endoscopic MVD.
目的： 探讨全程神经内镜技术在椎-基底动脉压迫型显微血管减压术中的手术方法、特殊技巧和手术疗效。方法： 对北京世纪坛医院2016年1月至2018年6月收治的13例椎-基底动脉作为直接或间接责任血管的脑神经疾病患者，进行了全程内镜下的显微血管减压术（MVD）治疗，其中面肌痉挛患者11例，三叉神经痛患者2例。回顾性分析其内镜手术过程和手术疗效。结果： 13例患者均顺利完成全程内镜下显微血管减压术。术中发现椎动脉直接压迫6例，基底动脉直接压迫2例，基底动脉移位推挤其他血管共同压迫5例（小脑上动脉1例，小脑前下动脉4例）。术中直接将垫棉置入压迫点2例，采用"预垫"技术放置垫棉7例，采用"架桥"技术放置垫棉4例。随访8~38个月，患者症状完全消失12例，明显改善1例。无术后出血、小脑梗死和颅内感染等严重并发症，无死亡病例。结论： 全程神经内镜下操作可完成椎-基底动脉压迫型MVD术，术中减压效果确实，手术疗效良好。灵活运用"预垫"和"架桥"等内镜下单手操作放置垫棉的特殊技术是顺利完成手术的重要技术保障。.
Keywords: Microvascular decompression; Neuroendoscopy; Vertebrobasilarartery.