Ma Qiufeng, Zhang Wenchuan, Li Guowei, Zhong Wenxiang, Yang Min, Zheng Xuesheng, Yang Xiaosheng, Li Shiting
From the Department of Neurosurgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Craniofac Surg. 2014 Sep;25(5):1810-3. doi: 10.1097/SCS.0000000000000990.
The objective of this paper is to study the therapeutic effect of microvascular decompression surgery on idiopathic hemifacial spasm with compression on different zones of facial nerve.
The clinical data of 348 patients with idiopathic hemifacial spasm treated by microvascular decompression surgery were retrospectively analyzed. Patients were divided into 5 groups according to compression on different zones of facial nerve by offending vessels. Root exit point was compressed in 18 patients (group A), transitional zone of brainstem was compressed in 42 patients (group B), attached segment of brainstem was compressed in 35 patients (group C), distal cisternal portion was compressed in 21 patients (group D), and 2 or more zones were compressed in 232 patients (group E). The therapeutic effect was observed, and outcome of excellent and partial good were regarded as effective.
Patients were followed up for 0.5 to 2 years. The effective rates were 94.4%, 95.2%, 97.1%, 95.2%, and 93.9% in group A, group B, group C, group D, and group E, respectively.No death occurred during operation,and there were no severe complications such as complete facial paralysis, intracranial hematoma, and hearing loss after operation.
Microvascular decompression surgery is the first choice for treatment hemifacial spasm. Proper detection of offending vessels and complete decompression may be the key factors to increase the cure rate.
本文旨在研究微血管减压术治疗面神经不同区域受压所致特发性面肌痉挛的疗效。
回顾性分析348例行微血管减压术治疗的特发性面肌痉挛患者的临床资料。根据责任血管对面神经不同区域的压迫情况将患者分为5组。18例患者为神经根出脑点受压（A组），42例患者为脑干过渡区受压（B组），35例患者为脑干附着段受压（C组），21例患者为脑池远端受压（D组），232例患者为2个或更多区域受压（E组）。观察治疗效果，将优和部分良的结果视为有效。
患者随访0.5至2年。A组、B组、C组、D组和E组的有效率分别为94.4%、95.2%、97.1%、95.2%和93.9%。术中无死亡病例，术后无完全性面瘫、颅内血肿、听力丧失等严重并发症。
微血管减压术是治疗面肌痉挛的首选方法。正确探测责任血管并彻底减压可能是提高治愈率的关键因素。
