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半面痉挛微血管减压术中面神经肌电图监测时侧向扩散反应的预后价值

Prognostic value of the lateral spread response for intraoperative electromyography monitoring of the facial musculature during microvascular decompression for hemifacial spasm.

作者信息

Kong Doo-Sik, Park Kwan, Shin Byoung-Gook, Lee Jeong Ah, Eum Dong-Ok

机构信息

Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

J Neurosurg. 2007 Mar;106(3):384-7. doi: 10.3171/jns.2007.106.3.384.

Abstract

OBJECT

The authors conducted a large retrospective study in which they evaluated the efficacy of intraoperative electromyography (EMG) monitoring of facial musculature during microvascular decompression (MVD) and assessed the predictive value of the lateral spread response (LSR) as a prognostic indicator for the treatment outcome of hemifacial spasm (HFS).

METHODS

The authors undertook intraoperative monitoring during MVD in 300 consecutive patients with HFS. The patients were divided into two groups based on whether the LSR disappeared or persisted following decompression. The mean follow-up period was 35.8 months (range 12-55 months). In 263 (87.7%) of the 300 patients, the LSR was observed during intraoperative facial EMG monitoring. In 230 (87.4%) of these 263 patients, the LSR disappeared following decompression (Group I), and in the remaining 33 patients (12.5%) the LSR persisted despite decompression (Group II). At the postoperative 1-year follow-up visit, there was a significant difference in clinical outcomes between both groups (p < 0.05).

CONCLUSIONS

Facial EMG monitoring of the LSR is an effective tool to use when performing complete decompression, and it may be helpful in predicting outcomes.

摘要

目的

作者进行了一项大型回顾性研究,评估微血管减压术(MVD)期间对面部肌肉组织进行术中肌电图(EMG)监测的疗效,并评估侧方扩散反应(LSR)作为面肌痉挛(HFS)治疗结果预后指标的预测价值。

方法

作者对300例连续性HFS患者在MVD期间进行术中监测。根据减压后LSR是否消失或持续存在,将患者分为两组。平均随访期为35.8个月(范围12 - 55个月)。300例患者中有263例(87.7%)在术中面部EMG监测时观察到LSR。在这263例患者中,230例(87.4%)减压后LSR消失(I组),其余33例(12.5%)尽管减压但LSR持续存在(II组)。在术后1年随访时,两组临床结果有显著差异(p < 0.05)。

结论

对面部LSR进行EMG监测是进行完全减压时的有效工具,可能有助于预测结果。

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