Garland P E, Patrinely J R, Anderson R L
Ophthalmology. 1987 Mar;94(3):288-94.
Hemifacial spasm (HFS) is a disorder characterized by unilateral involuntary spasm of the muscles innervated by the facial nerve (cranial nerve VII). The etiology is often a redundant or ectatic artery in the cerebellopontine angle that compresses the facial nerve. Neurosurgical decompression with implantation of a sponge between the ectatic artery and the facial nerve produces good results, but has a high complication rate and a poor patient acceptance rate. Various modes of peripheral neurectomy have also been advocated, but the recurrence rate is high and the preexisting functional and cosmetic eyelid deformities are exacerbated. The results of unilateral periorbital myectomy in 21 HFS patients are presented. Follow-up ranging from 1 to 7 years was available on 16 patients. Excellent or good results were obtained in 94% of these cases, and postoperative complications were minor. Transient lymphedema and forehead anesthesia are the most common complications. An unforseen benefit of periorbital myectomy surgery is the improvement or relief of lower facial contractions that occurred in 75% of patients. The authors believe the myectomy procedure is a safe, effective, predictable therapy for those HFS patients unwilling to risk a neurosurgical operation, and allows simultaneous reconstruction of associated eyelid and eyebrow deformities.
面肌痉挛（HFS）是一种以面神经（颅神经VII）支配的肌肉单侧不自主痉挛为特征的疾病。其病因通常是桥小脑角处的一条多余或扩张的动脉压迫面神经。在扩张的动脉与面神经之间植入海绵进行神经外科减压可产生良好效果，但并发症发生率高，患者接受率低。也有人主张采用各种外周神经切除术，但复发率高，且会加重原有的功能性和美容性眼睑畸形。本文介绍了21例面肌痉挛患者行单侧眶周肌切除术的结果。16例患者获得了1至7年的随访。这些病例中有94%取得了优异或良好的效果，术后并发症轻微。短暂性淋巴水肿和前额麻木是最常见的并发症。眶周肌切除术意外的好处是75%的患者下面部痉挛得到改善或缓解。作者认为，对于那些不愿冒神经外科手术风险的面肌痉挛患者，肌切除术是一种安全、有效、可预测的治疗方法，并且可以同时修复相关的眼睑和眉毛畸形。
