Li Ning, Zhao Wei-Guo, Pu Chun-Hua, Yang Wen-Lei
Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Acta Neurochir (Wien). 2018 Jan;160(1):145-150. doi: 10.1007/s00701-017-3368-9. Epub 2017 Oct 26.
This prospective study quantitatively measured the cerebellar retraction factors, including retraction distance, depth and duration, and evaluated their potential relationship to the development of hearing loss after microvascular decompression (MVD) for hemifacial spasm (HFS).
One hundred ten patients with primary HFS who underwent MVD in our department were included into this study. The cerebellar retraction factors were quantitatively measured on preoperative MR and timed during MVD. Associations of cerebellar retraction and other factors to postoperative hearing loss were analyzed.
Eleven (10%) patients developed hearing loss after MVD. Compared with the group without hearing loss, the cerebellar retraction distance, depth and duration of the group with hearing loss were significantly greater (p < 0.05). Multivariate regression analysis showed that greater cerebellar retraction depth and longer retraction duration were significantly associated with a higher incidence of postoperative hearing impairment (p < 0.05).
This study strongly suggested a correlation between the cerebellar retraction factors, especially retraction depth and duration, and possibility of hearing loss following MVD for HFS.
本前瞻性研究定量测量了小脑牵拉因素，包括牵拉距离、深度和持续时间，并评估了它们与微血管减压术（MVD）治疗面肌痉挛（HFS）后听力损失发生发展的潜在关系。
本研究纳入了在我科接受MVD治疗的110例原发性HFS患者。在术前磁共振成像（MR）上对小脑牵拉因素进行定量测量，并在MVD期间进行计时。分析小脑牵拉及其他因素与术后听力损失的相关性。
11例（10%）患者在MVD后出现听力损失。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、深度和持续时间显著更长（p<0.05）。多因素回归分析显示，更大的小脑牵拉深度和更长的牵拉持续时间与术后听力障碍的更高发生率显著相关（p<0.05）。
本研究有力地表明，小脑牵拉因素，尤其是牵拉深度和持续时间，与HFS的MVD术后听力损失的可能性之间存在相关性。
