摘要
目的探讨微血管减压术治疗面肌痉挛的手术要点及有效性和安全性。方法共54例面肌痉挛患者,责任血管分别为小脑前下动脉32例(59.26%)、小脑后下动脉11例(20.37%)、椎动脉5例(9.26%),其中6例(11.11%)为多责任血管,均行微血管减压术。结果 54例患者平均随访2年,面肌痉挛治愈46例(85.19%)、明显缓解5例(9.26%)、部分缓解2例(3.70%)、无效1例(1.85%),总有效率为94.44%(51/54)。术后出现轻度面瘫4例(7.41%)、听力下降2例(3.70%)、延迟治愈4例(7.41%),无一例发生颅内血肿、颅内感染和脑脊液漏,无死亡病例。结论微血管减压术治疗面肌痉挛安全、有效。熟练的手术技巧、准确的责任血管判定、面神经有效减压是手术成功的关键,术中神经电生理学监测可以实时判断手术疗效、减少术后并发症。
Objective To analyze the operating points and evaluate the therapeutic efficacy and safety of microvascular decompression（MVD） for hemifacial spasm（HFS）. Methods The clinical data of 54 patients with HFS underwent MVD were analyzed retrospectively. The offending vessels included anterior inferior cerebellar artery（AICA） in 32 cases（59.26%）, posterior inferior cerebellar artery（PICA） in 11 cases（20.37%）, vertebral artery（VA） in 5 cases（9.26%）, both AICA and PICA in 6 cases（11.11%）.Results After an average of 2 years of follow-up, 46 cases（85.19%） were completely relieved, 5 cases（9.26%） were markedly relieved, 2 cases（3.70%） were partially relieved, and one case（1.85%） had no significant change. The total effective rate was 94.44%（51/54）. There were 4 cases（7.41%） with mild facial paralysis, 2 cases（3.70%） with hearing loss, and 4 cases（7.41%） with delayed resolution after operation, and no intracranial hematoma, intracranial infection, cerebrospinal fluid（CSF） leakage or death occurred during the perioperative period. Conclusions MVD is effective and safe in the treatment of HFS. Adept operation skills, correct identification of offending vessels, and effective decompression are the key to successful operation. Intraoperative electrophysiological monitoring can be used to identify the effect of operation and reduce postoperative complications.
作者
许中华
唐炎燊
严耀华
XU Zhong-hua;TANG Yan-shen;YAN Yao-hua(Department of Neurosurgery,Rugao Boai Hospital,Rugao 226500,Jiangsu,China;Department of Neurosurgery,Affiliated Hospital of Nantong University,Nantong 226000,Jiangsu,China)
出处
《中国现代神经疾病杂志》
CAS
北大核心
2018年第10期754-757,共4页
Chinese Journal of Contemporary Neurology and Neurosurgery
