微血管减压术治疗面肌痉挛时异常肌反应监测的价值。
The value of abnormal muscle response monitoring during microvascular decompression surgery for hemifacial spasm.
机构信息
Department of Neurosurgery, XinHua Hospital, Shanghai JiaoTong University School of Medicine, The Cranial Nerve Disease Center of Shanghai, 1665 KongJiang Rd, Shanghai 200092, China.
出版信息
Int J Surg. 2011;9(4):347-51. doi: 10.1016/j.ijsu.2011.02.010. Epub 2011 Mar 15.
BACKGROUND AND OBJECTIVES
Abnormal muscle response (AMR) to the electrical stimulation of a branch of facial nerve is a specific electrophysiological feature of primary hemifacial spasm (HFS). The aim of this study was to evaluate the value of AMR monitoring during microvascular decompression surgery (MVD), and the correlation between the AMR changes and the clinical outcomes.
METHODS
This study included 241 cases of MVDs. Intraoperative AMR monitoring was performed for each subject. The patients were divided into two groups based on whether the AMR-disappeared or not following decompression of the facial nerve.
RESULTS
Postoperatively, 229 (95.0%) patients were relieved from the spasm, 215 (93.9%) occurred in the AMR-disappeared group, 14 (6.1%) in the non-AMR-disappeared group. The correlation between intraoperative AMR abolition and HFS relief was statistically significant.
CONCLUSIONS
Intraoperative AMR monitoring was an effective assistant for a successful MVD for the patient with HFS. It is worth being routinely employed during the operation.
背景与目的
面神经分支异常肌肉反应（AMR）是原发性面肌痉挛（HFS）的一种特定电生理特征。本研究旨在评估 AMR 监测在微血管减压手术（MVD）中的价值，以及 AMR 变化与临床结果之间的相关性。
方法
本研究纳入了 241 例 MVD 患者。对每位患者均进行术中 AMR 监测。根据面神经减压后 AMR 是否消失将患者分为两组。
结果
术后 229 例（95.0%）患者痉挛得到缓解，其中 AMR 消失组 215 例（93.9%），非 AMR 消失组 14 例（6.1%）。术中 AMR 消失与 HFS 缓解之间存在显著相关性。
结论
术中 AMR 监测是治疗 HFS 的有效辅助手段，有助于提高 MVD 的成功率。在手术中常规应用具有一定价值。
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