Ray Dibyendu K, Bahgat Diaa, McCartney Shirley, Burchiel Kim J
Department of Neurological Surgery, Oregon Health & Science University, Portland, Oreg. 97239, USA.
Stereotact Funct Neurosurg. 2010;88(6):383-9. doi: 10.1159/000319883. Epub 2010 Oct 15.
Hemifacial spasm (HFS) is a movement disorder characterized by intermittent, involuntary clonic or tonic-clonic contractions of muscles innervated by the ipsilateral facial nerve. Recent studies have documented change in quality of life after HFS management with botulinum toxin injection. However, we failed to locate any study that documented change in quality of life after surgical management with retrosigmoid microvascular decompression (MVD).
Our study objectives were 3-fold. Firstly, to use a disease-specific, validated quality of life assessment scale to document any change in quality of life after MVD for HFS. Secondly, to determine the time period in which the majority of patients undergoing MVD could be expected to benefit from surgery. Finally, to determine factors affecting the postoperative quality of life following MVD. A retrospective analysis of HFS patients treated with MVD at a single institution by a single surgeon (K.J.B.) between January 2000 and December 2007 was undertaken. A modification of a previously developed validated disease-specific quality of life assessment scale that included the addition of a parameter for difficulty in sleep was used to assess quality of life before and after surgery.
A total of 21 patients (14 female and 7 male) underwent treatment as specified. Eighty-five percent (17/20) of the patients reported prolonged remission of symptoms (mean follow-up period = 4.15 years). Five percent (1/20) reported occasional recurrence of twitches. The overall mean quality of life score improved from 11.1 preoperatively to 2.2 postoperatively.
MVD offers significant and prolonged improvement in quality of life for the HFS patients we studied, as measured using a disease-specific, validated quality of life assessment scale. Postoperative quality of life, however, was strongly influenced by both the success of surgery in resolving the symptoms and the absence of any permanent complications of surgery.
面肌痉挛（HFS）是一种运动障碍性疾病，其特征为同侧面神经支配的肌肉出现间歇性、不自主的阵挛性或强直性阵挛性收缩。最近的研究记录了肉毒杆菌毒素注射治疗面肌痉挛后生活质量的变化。然而，我们未能找到任何记录乙状窦后微血管减压术（MVD）手术治疗后面肌痉挛患者生活质量变化的研究。
我们的研究目标有三个方面。首先，使用一种经过验证的特定疾病生活质量评估量表，记录面肌痉挛患者接受MVD手术后生活质量的任何变化。其次，确定大多数接受MVD手术的患者有望从手术中获益的时间段。最后，确定影响MVD手术后生活质量的因素。对2000年1月至2007年12月期间在单一机构由单一外科医生（K.J.B.）进行MVD治疗的面肌痉挛患者进行回顾性分析。使用先前开发的经过验证的特定疾病生活质量评估量表的修改版本，该版本增加了睡眠困难参数，用于评估手术前后的生活质量。
共有21例患者（14例女性和7例男性）接受了指定治疗。85%（17/20）的患者报告症状长期缓解（平均随访期 = 4.15年）。5%（1/20）的患者报告偶尔有抽搐复发。总体生活质量平均得分从术前的11.1提高到术后的2.2。
使用经过验证的特定疾病生活质量评估量表测量，MVD为我们研究的面肌痉挛患者的生活质量带来了显著且持久的改善。然而，术后生活质量受到手术缓解症状的成功程度以及手术无任何永久性并发症的强烈影响。
