Amano Yuki, Asayama Bunsho, Noro Shusaku, Abe Takenori, Okuma Masahiro, Honjo Kaori, Seo Yoshinobu, Nakamura Hirohiko
Department of Neurosurgery, Nakamura Memorial Hospital.
Department of Neurology, Nakamura Memorial Hospital.
Neurol Med Chir (Tokyo). 2025 Feb 15;65(2):45-51. doi: 10.2176/jns-nmc.2024-0062. Epub 2024 Dec 10.
Although microvascular decompression (MVD) is a reliable treatment for hemifacial spasm (HFS), delayed postoperative relief is one of its main issues. We previously evaluated the morphology of the lateral spread response (LSR) and reported the correlation between delayed relief after MVD and polyphasic morphology of the LSR. The purpose of this study was to investigate the correlation between the morphology of the LSR with stimulation of the temporal and mandibular branches of the facial nerve and delayed relief of persistent HFS after MVD. We retrospectively analysed and compared data from 49 of 205 consecutive patients who underwent MVD for HFS at our hospital between January 2015 and March 2022. Based on the pattern of the initial LSR morphology, patients were divided into 4 groups (LSR with temporal branch stimulation/LSR with mandibular branch stimulation; polyphasic/polyphasic group, polyphasic/monophasic group, monophasic/polyphasic group, monophasic/monophasic group). The results of MVD surgery for HFS were evaluated 1 week, 1 month and 1 year postoperatively, by evaluating whether or not the symptoms of HFS persisted at the time of each follow-up. We found significant differences in residual postoperative HFS 1 week postoperatively among the 4 groups (p < 0.05), as assessed using m*n Yates chi-square test. There is a significant correlation between delayed relief after MVD and polyphasic morphology of the initial LSR in patients with HFS. The LSR with temporal rather than mandibular branch stimulation might be useful for predicting delayed relief following MVD in HFS patients.
尽管微血管减压术（MVD）是治疗面肌痉挛（HFS）的可靠方法，但术后缓解延迟是其主要问题之一。我们之前评估了侧方扩散反应（LSR）的形态，并报告了MVD术后缓解延迟与LSR多相形态之间的相关性。本研究的目的是探讨面神经颞支和下颌支刺激下LSR的形态与MVD后持续性HFS缓解延迟之间的相关性。我们回顾性分析并比较了2015年1月至2022年3月在我院接受MVD治疗HFS的205例连续患者中的49例的数据。根据初始LSR形态模式，将患者分为4组（颞支刺激的LSR/下颌支刺激的LSR；多相/多相组、多相/单相组、单相/多相组、单相/单相组）。在术后1周、1个月和1年对HFS的MVD手术结果进行评估，通过评估每次随访时HFS症状是否持续存在。使用m*n Yates卡方检验评估，我们发现4组患者术后1周残余HFS存在显著差异（p < 0.05）。HFS患者MVD术后缓解延迟与初始LSR的多相形态之间存在显著相关性。面神经颞支而非下颌支刺激的LSR可能有助于预测HFS患者MVD后的缓解延迟。
