微血管减压术治疗非典型面肌痉挛的结果：14例病例报告及文献综述
Results of Atypical Hemifacial Spasm with Microvascular Decompression: 14 Case Reports and Literature Review.
作者信息
Zhao Hua, Zhang Xin, Zhang Ying, Tang Yin-Da, Zhu Jin, Wang Xu-Hui, Ying Ting-Ting, Li Shi-Ting
机构信息
Department of Neurosurgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Orthopedics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
World Neurosurg. 2017 Sep;105:605-611. doi: 10.1016/j.wneu.2017.06.030. Epub 2017 Jun 12.
BACKGROUND
Few studies have examined atypical hemifacial spasm (AHFS), and the mechanism of AHFS remains unclear. In this study, we examined the etiology, prognosis, and treatment of AHFS.
METHODS
We retrospectively analyzed the clinical data for 14 consecutive patients that underwent microvascular decompression (MVD) for AHFS between January 2014 and December 2015. Clinical features, outcomes, and complications were evaluated.
RESULTS
The incidence of AHFS is 1.52%. There were no significant differences in sex, age, side and duration between the typical hemifacial spasm and AHFS. During the follow-up period, the effective rate of MVD for patients with AHFS was 92.3%. Three patients developed delayed facial nerve palsy postoperatively, 1 patient experienced occipital sensory disturbance, and 1 patient suffered hearing loss.
CONCLUSIONS
Most of the cases of AHFS studied here were caused by neurovascular conflict in zone IV of the facial nerve distal to the root entry zone. MVD surgery is the first choice treatment for AHFS.
背景
很少有研究对非典型面肌痉挛（AHFS）进行过研究，AHFS的发病机制仍不清楚。在本研究中，我们对AHFS的病因、预后及治疗进行了研究。
方法
我们回顾性分析了2014年1月至2015年12月期间连续14例行微血管减压术（MVD）治疗AHFS患者的临床资料。评估了临床特征、治疗效果及并发症。
结果
AHFS的发病率为1.52%。典型面肌痉挛与AHFS在性别、年龄、患侧及病程方面无显著差异。随访期间，AHFS患者MVD的有效率为92.3%。3例患者术后出现迟发性面神经麻痹，1例患者出现枕部感觉障碍，1例患者出现听力丧失。
结论
本研究中大多数AHFS病例是由面神经入根区远端IV区的神经血管冲突引起的。MVD手术是AHFS的首选治疗方法。
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