Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing, China.
Department of International Medical Service, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing, China.
Neurol Res. 2021 Mar;43(3):173-180. doi: 10.1080/01616412.2020.1833158. Epub 2020 Oct 12.
Although studies have indicated that the small posterior fossa plays a role in hemifacial spasm (HFS), few studies have denoted the correlations between local measurements of the cerebellopontine angle and the incidence of HFS and surgical outcomes.
We retrospectively analyzed the demographic and clinical data of HSF patients who underwent microvascular decompression at our institution. Healthy controls were recruited. The divergent prognosis of HFS was defined as an ordinal variable. A multivariable ordinal regression model was generated to estimate the relationship between the variables and outcomes of HFS.
Between 2013 and 2018, 180 patients who were enrolled in our study met the inclusion criteria. Compared with the control group (n = 94), HFS patients had a smaller internal acousticmeatus-brainstem distance (P < 0.001) on the unaffected side and a larger facial nerve-brainstem angle (P < 0.001). The regression analysis demonstrated that subgroups with more severe facial nerve compression (mild vs severe, OR = 0.269, P = 0.018; moderate vs severe, OR = 0.215, P < 0.001) and a thinner brainstem (OR = 2.368, P = 0.014) were more likely to experience better short-term outcomes, while subgroups with a thinner brainstem (OR = 5.583, P = 0.007) were more likely to experience better long-term outcomes.
Structural changes occurring in patients are risk factors for HFS. The patient's local neurovascular structure and brainstem volume are factors that significantly influence short-term and long-term surgical outcomes.
尽管研究表明小颅后窝在面肌痉挛（HFS）中起作用，但很少有研究指出小脑脑桥角的局部测量值与 HFS 的发病率和手术结果之间的相关性。
我们回顾性分析了在我院接受微血管减压术的 HFS 患者的人口统计学和临床数据。招募了健康对照组。HFS 的不同预后被定义为有序变量。生成多变量有序回归模型，以估计变量与 HFS 结果之间的关系。
在 2013 年至 2018 年期间，我们的研究共纳入了 180 名符合纳入标准的患者。与对照组（n=94）相比，HFS 患者未受影响侧的内听道-脑干距离更小（P<0.001），面神经-脑干角度更大（P<0.001）。回归分析表明，面神经受压更严重的亚组（轻度 vs 重度，OR=0.269，P=0.018；中度 vs 重度，OR=0.215，P<0.001）和脑干更薄的亚组（OR=2.368，P=0.014）更有可能获得更好的短期结果，而脑干更薄的亚组（OR=5.583，P=0.007）更有可能获得更好的长期结果。
患者发生的结构变化是 HFS 的危险因素。患者的局部神经血管结构和脑干体积是显著影响短期和长期手术结果的因素。
