Li Ning, Zhao Wei-Guo, Pu Chun-Hua, Yang Wen-Lei
Department of Neurosurgery, Rui Jin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Department of Neurosurgery, Rui Jin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
World Neurosurg. 2017 Jun;102:97-101. doi: 10.1016/j.wneu.2017.02.137. Epub 2017 Mar 10.
This study prospectively investigated the relationship between cerebellar retraction factors measured on preoperative magnetic resonance and the development of postoperative hearing loss and evaluated their potential role in predicting the possibility of hearing loss after microvascular decompression (MVD) for hemifacial spasm (HFS).
The study included 110 patients clinically diagnosed with primary HFS who underwent MVD in our department. The cerebellar retraction factors were quantitatively measured on preoperative magnetic resonance. Associations of cerebellar retraction and other risk factors with postoperative hearing loss were analyzed.
Eleven patients (10%) developed nonserviceable hearing loss after MVD. Compared with the group without hearing loss, the cerebellar retraction distance and depth of the group with hearing loss were significantly greater (P < 0.05). Multivariate logistic regression analysis showed that greater cerebellar retraction depth was significantly associated with the higher incidence of postoperative hearing loss (P < 0.05).
The results in this study strongly suggested the correlation between the cerebellar retraction depth and the possibility of hearing loss after MVD for HFS. In addition, cerebellar retraction depth could be considered as a useful tool to predict the risk of post-MVD hearing loss.
本研究前瞻性地调查了术前磁共振成像测量的小脑牵拉因素与术后听力损失发生之间的关系,并评估了它们在预测面肌痉挛(HFS)微血管减压术(MVD)后听力损失可能性方面的潜在作用。
本研究纳入了110例在我科接受MVD治疗的临床诊断为原发性HFS的患者。在术前磁共振成像上对小脑牵拉因素进行定量测量。分析小脑牵拉及其他危险因素与术后听力损失的相关性。
11例患者(10%)在MVD后出现失用性听力损失。与未发生听力损失的组相比,发生听力损失组的小脑牵拉距离和深度明显更大(P < 0.05)。多因素逻辑回归分析显示,更大的小脑牵拉深度与术后听力损失的更高发生率显著相关(P < 0.05)。
本研究结果强烈提示小脑牵拉深度与HFS的MVD术后听力损失可能性之间存在相关性。此外,小脑牵拉深度可被视为预测MVD术后听力损失风险的有用工具。