显微血管减压术治疗面肌痉挛51例临床分析

The clinical observation of microvascular decompression for hemifacial spasm

摘要:

目的 探讨显微血管减压术治疗特发性面肌痉挛疗效。方法 回顾分析显微血管减压术治疗51例面肌痉挛的临床资料,术中确认责任血管并减压。结果 本组均能见到面神经出脑干处有动脉血管压迫,其中AICA26例(51.0%),PICA16例(31.3%),VA4例(7.8%),复合型5例(9.8%)。43例(84.4%)术后症状完全缓解,8例术后减轻(15.6%)。其中4例(7.8%)3周内停止抽搐,3例(5.8%)3月后抽搐停止,1例(2%)一直未完全缓解。随访1年以上,复发1例(2.0%)。结论 显微血管减压是面肌痉挛的首选方法,术中确认责任血管,充分减压和防止副损伤是手术成功的关键。

Abstract:

Objective The purpose of this study was to explore the efficacy of microvascular decompression(MVD) for hemifacial spasm(HFS).Methods We reviewed retrospectively the clinical data of 51 patients who suffered from hemifacial spasm and undergone MVD in our hospital.Results The compression to REZ could be observed during surgery with no exception. Among these offending arterial loops, AICA, 26 cases(51.0%), PICA,16 cases(31.3%), VA,4 cases(7.8%), the combination of two arteries,5 cases(9.8%). Among all patients who undergone MVD for HFS, 43 individuals are completely relieved, 8 alleviated, 4 stopped twitching within three weeks and another 3 stopped twitching after three months. And only one patient had no significant improvement following surgery. One patient recurred after surgery.Conclusions MVD should be the first choice in the treatment of HFS. The confirming of offending artery loop, complete depression of REZ and avoiding injury to other important structures play a key role during the operation.