桥小脑角区血管减压术治疗面肌痉挛时脑干听觉诱发电位Ⅰ波缺失的意义。
Significance of wave I loss of brainstem auditory evoked potentials during microvascular decompression surgery for hemifacial spasm.
机构信息
Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
出版信息
Clin Neurophysiol. 2020 Apr;131(4):809-815. doi: 10.1016/j.clinph.2019.12.409. Epub 2020 Jan 21.
OBJECTIVE
We sought to define the significance of wave I loss of brainstem auditory evoked potentials (BAEPs) during microvascular decompression (MVD) surgery for hemifacial spasm.
METHODS
Out of 670 patients, 36 showed wave V loss during MVD surgery. These patients were classified into the following two groups based on wave I loss: Total wave loss, including wave I loss, and wave V loss with persistent wave I. We analyzed the differences in postoperative complications between the groups. We also investigated when wave I loss occurred during MVD surgery.
RESULTS
Of the 36 patients, 24 (66.7%) exhibited wave I persistence and 12 (33.3%) exhibited total wave loss. The patients who showed total wave loss were significantly more likely to exhibit postoperative hearing loss (p = 0.009). In addition, these patients exhibited a significantly higher frequency of postoperative complications such as dizziness and tinnitus (p = 0.002 and p = 0.031, respectively). Total wave loss occurred more frequently after the decompressive procedure of MVD surgery.
CONCLUSIONS
Total wave loss, including wave I loss, was more closely associated with severe postoperative complications. Total wave loss occurred more frequently after the decompressive procedure of MVD surgery.
SIGNIFICANCE
These findings suggest the significance of wave I loss of BAEPs.
目的
我们旨在确定在微血管减压（MVD）手术治疗面肌痉挛期间，脑干听觉诱发电位（BAEP）I 波缺失的意义。
方法
在 670 例患者中，有 36 例在 MVD 手术中出现 V 波缺失。这些患者根据 I 波缺失情况分为以下两组：完全波缺失，包括 I 波缺失和 V 波缺失伴持续 I 波；我们分析了两组术后并发症的差异。我们还研究了 I 波缺失在 MVD 手术中何时发生。
结果
在 36 例患者中，有 24 例（66.7%）表现为 I 波持续存在，有 12 例（33.3%）表现为完全波缺失。完全波缺失的患者术后听力损失的可能性显著更高（p=0.009）。此外，这些患者术后出现头晕和耳鸣等并发症的频率显著更高（p=0.002 和 p=0.031）。完全波缺失更常发生在 MVD 手术减压程序之后。
结论
包括 I 波缺失在内的完全波缺失与严重的术后并发症更为密切相关。完全波缺失更常发生在 MVD 手术减压程序之后。
意义
这些发现提示了 BAEP 的 I 波缺失的意义。
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