Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, China.
Department of Rehabilitation, Affiliated Hospital of Qingdao University, Qingdao, China.
World Neurosurg. 2020 Feb;134:e12-e15. doi: 10.1016/j.wneu.2019.08.105. Epub 2019 Aug 26.
We explored the risk factors for the occurrence of delayed facial paralysis (DFP) after microvascular decompression (MVD) for hemifacial spasm (HFS).
A retrospective study was conducted of 636 patients who had undergone MVD for HFS by the same neurosurgery department of China-Japan Friendship Hospital from January 2006 to May 2016. Of the 636 patients, 50 (7.9%) had presented with DFP, which had developed from 2 to 60 days postoperatively (average, 12.9 ± 10.0005 days). All 50 patients with DFP had recovered completely within 10-300 days (average, 88.7 ± 61.389 days) after the onset of DFP. We randomly selected 100 patients from the 586 patients without DFP as the control group. Univariate and multivariate logistic analyses were used to analyze the risk factors involved in the occurrence of DFP.
Univariate analysis showed that the disease course was the only factor associated with the development of DFP (P = 0.003). Furthermore, on multivariate logistic analysis, the course of HFS was the only risk factor associated with the development of DFP (P = 0.01). Additionally, the Spearman test revealed a positive correlation between the onset of DFP and the duration of the DFP symptoms (r = 0.682; P < 0.001).
Although DFP frequently occurred after MVD, it can recover spontaneously. The longer the course of HFS, the more frequently DFP will occur after MVD. The earlier that DFP develops, the shorter will be the time to recovery.
探讨微血管减压术（MVD）治疗面肌痉挛（HFS）后面神经迟发性麻痹（DFP）的发生危险因素。
回顾性分析 2006 年 1 月至 2016 年 5 月中国医学科学院北京协和医学院中日友好医院神经外科同一治疗组收治的 636 例行 MVD 治疗的 HFS 患者的临床资料，其中 50 例（7.9%）出现 DFP，术后 2～60 d 出现 DFP（平均 12.9±10.0005 d）。所有患者 DFP 均在出现 DFP 后 10～300 d 内完全恢复（平均 88.7±61.389 d）。随机选取同期 586 例未发生 DFP 的患者作为对照组。采用单因素和多因素 logistic 分析分析 DFP 发生的危险因素。
单因素分析显示，病程是唯一与 DFP 发生相关的因素（P=0.003）。多因素 logistic 分析显示，病程是唯一与 DFP 发生相关的危险因素（P=0.01）。Spearman 检验显示 DFP 发病与 DFP 症状持续时间呈正相关（r=0.682，P<0.001）。
MVD 后面神经迟发性麻痹虽较常见，但可自行恢复。HFS 病程越长，MVD 后 DFP 发生率越高，发病越早，恢复时间越短。
