Zhao Hua, Zhang Xin, Tang Yin-da, Zhang Ying, Ying Ting-Ting, Zhu Jin, Li Shi-Ting
Department of Neurosurgery, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Orthopedics, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
World Neurosurg. 2017 Nov;107:559-564. doi: 10.1016/j.wneu.2017.08.028. Epub 2017 Aug 18.
Although microvascular decompression (MVD) surgery is considered the gold standard treatment for hemifacial spasm, there are some MVD-related complications.
We retrospectively reviewed 1548 patients with hemifacial spasm who underwent retromastoid suboccipital craniectomy with MVD from January 2009 to June 2013. All patients were followed for >2 years.
Excellent and good results were 92.5% and 4.2%, respectively. Postoperative complications were recorded in 16.09% (n = 249). There was no MVD-related mortality. After MVD surgery, the most frequent complications were occipital sensory disturbance (7.3%), facial nerve palsy (9.7%), and hearing impairment (3.5%). Other complications were as follows: cerebrospinal fluid leakage (n = 24), poor healing wound (n = 14), lower cranial nerve palsy (n = 12), wound infection (n = 4), and hemorrhage (n = 2).
MVD operation is a safe treatment for hemifacial spasm. Facial nerve palsy is the most common MVD-related complication; preservation of the lesser occipital nerve during MVD surgery can decrease the rate of occipital sensory disturbance. Permanent or serious complications are comparatively rare in MVD surgery.
尽管微血管减压术（MVD）被认为是治疗面肌痉挛的金标准，但仍存在一些与MVD相关的并发症。
我们回顾性分析了2009年1月至2013年6月期间接受乳突后枕下开颅微血管减压术治疗的1548例面肌痉挛患者。所有患者均随访超过2年。
优良率分别为92.5%和4.2%。术后并发症发生率为16.09%（n = 249）。无与MVD相关的死亡病例。微血管减压术后，最常见的并发症是枕部感觉障碍（7.3%）、面神经麻痹（9.7%）和听力障碍（3.5%）。其他并发症如下：脑脊液漏（n = 24）、伤口愈合不良（n = 14）、下颅神经麻痹（n = 12）、伤口感染（n = 4）和出血（n = 2）。
微血管减压术是治疗面肌痉挛的一种安全方法。面神经麻痹是最常见的与微血管减压相关的并发症；在微血管减压术中保留枕小神经可降低枕部感觉障碍的发生率。在微血管减压术中，永久性或严重并发症相对少见。
