Microvascular Decompression In The Treatment Of Hemifacial Spasm And The Clinical Analysis Of43Cases

Objective: To explore the microvascular decompression (Microvasculardecompression, MVD) in treatment of hemifacial spasm (Hemifacial spasm, HFS), andthe clinical value of operation in treatment and prevention of complication.Methods: A retrospective analysis of43patients with hemifacial spasm fromDalian Central Hospital from2010May to2013January. All are the first operationcases, including14male,29female, age from38to71years old, average52years.Thecourse of disease was6months to20years, average5.2years. And25are Left,18areright.Judged according to spasm intensity classification established by Cohen,2casesare in1class,17cases are in2class,21cases are in3class,3cases are in4class. Allpatients underwent physiotherapy,acupuncture, RF or drug treatment before are Invalid,Underwent facial nerve MRI+MRTA (Magnetic resonance tomographic angiography)examination help exclude secondary cause of disease and preliminarily determineresponsible vascular of hemifacial spasm.With general anesthesia and post ears straightincision and retrosigmoid approach,microvascular decompression is taken in thetreatment of vascular,confirm the responsible vessels in the operation,and Teflon cottonpad from the facial nerve root. Complications are observed in patients after operationand recover.This paper analyses the causes and treatment of complications afteroperation.Results: In this group, after more than3months follow-up operation, of the43cases,41cases were cured,1cases was partly cured, the cure rate was95.3%, the totaleffective rate was97.6%. Of the43cases, responsible vessels is the anterior inferiorcerebellar artery in26cases (60.4%),posterior cerebellar artery in13cases (30.2%),vertebral artery in1cases (2.3%), anterior inferior cerebellar artery with posteriorinferior cerebellar artery in3cases(6.9%). Dizziness, headache, nausea, vomiting,appeared in30cases during postoperative, accounting for about70%, of which17cases associated with other complications:6cases with hearing impairment, accounting forabout14%;2cases of tinnitus, accounting for about4.6%;4cases with delayed facialparalysis, accounting for about9.3%;1cases with cerebrospinal fluidleakage,accounted for about2.3%;4cases with aseptic meningitis,accounted for about9.3%;5cases of herpes labialis, accounting for about11.6%, other complications suchas1cases with drinking cough, accounting for about2.3%of,1cases with abducensparalysis, accounting for2.3%. No infection and intracranial hematoma, brain steminjury and cerebral hemorrhage were appeared.Conclusion: MVD is currently the most effectivehe treatment of Hemifacial spasm,and relatively safe method, regulation of the operation,correct position,suitable bonehole,skilled microsurgical technique can obtain satisfactory operation effect. Throughreducing mechanical facial nerve stimulation of the surgery, minimizing the numberand volume, with little cotton pad,and positive treatment of vasospasm measures,we caneffectively reduce the postoperative incidence of delayed facial paralysis and shortenthe course of disease.