Jeon Chiman, Jung Na Young, Kim Minsoo, Park Kwan
Department of Neurosurgery, Korea University Ansan Hospital, Ansan 15355, Republic of Korea.
Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea.
Life (Basel). 2023 Jul 24;13(7):1616. doi: 10.3390/life13071616.
This review article discusses the clinical significance of intraoperative neurophysiological monitoring (IONM), provides recommendations for monitoring protocols, and considers the interpretation of results in microvascular decompression (MVD) for hemifacial spasm (HFS). The lateral spread response (LSR) is an important monitoring parameter during MVD. It helps to identify the responsible blood vessel and confirms its thorough decompression from the facial nerve. The disappearance of the LSR during surgery is associated with favorable clinical outcomes. Standard and revised monitoring protocols and the confirmation of LSR persistence and disappearance are also discussed. The blink reflex and other facial nerve monitoring modalities, such as free-running electromyography, facial motor evoked potentials, F-waves, and the Z-L response, are further considered.
这篇综述文章讨论了术中神经生理监测（IONM）的临床意义，为监测方案提供了建议，并探讨了在微血管减压术（MVD）治疗面肌痉挛（HFS）中结果的解读。侧方扩散反应（LSR）是MVD术中一个重要的监测参数。它有助于识别责任血管，并确认其已从面神经彻底减压。手术中LSR的消失与良好的临床结果相关。还讨论了标准和修订的监测方案以及LSR持续存在和消失的确认。进一步探讨了眨眼反射和其他面神经监测方式，如自发电肌电图、面肌运动诱发电位、F波和Z-L反应。
