The Value Of Preoperative Magnetic Resonance Hydrography Of Facial Nerve,3D-TOF-MRA And Intraoperative Electrophysiological Monitoring In The Treatment Of Facial Spasm MVD

Purpose To investigate the effects of the types of compression of facial nerve and peripheral blood vessels on preoperative magnetic resonance imaging(MRI)and intraoperative neuroelectrophysiological monitoring(IONM)in improving the prognosis of patients with HFS MVD,reducing postoperative complications and Enhanced recovery after surgery.Methods The clinical data and follow-up data of facial spasm(HFS)patients who underwent MVD from August 2013 to December 2018 in the first affiliated Hospital of Fujian Medical University were analyzed retrospectively.121 patients met the inclusion criteria.According to preoperative MRI,the types of facial nerve compression and peripheral vascular compression were determined and divided into simple compression group(50 cases)and complex compression group(71 cases).According to whether or not IONM is used during the operation,they were divided into electrophysiological group(n = 30)and non-electrophysiological group(n = 91).The clinical control study was used to compare and analyze the difference of postoperative curative effect,postoperative complication rate,the days of hospitalization and the cost of hospitalization in each group.Results There was no significant difference between the simple compression group and the complex compression group in the operative time,postoperative curative effect,the incidence of postoperative complications,the days of hospitalization and the hospitalization expenses(P>0.05).In electrophysiological group and non-electrophysiological group,there were statistical differences in the incidence of postoperative complications,the days of hospitalization and the cost of hospitalization(P<0.05).There was no significant difference in the operative time,postoperative curative effect(P > 0.05).The incidence of postoperative complications in electrophysiological group(6.7%)was significantly lower than that in non-electrophysiological group(26.4%),and the days of hospitalization in electrophysiological group(5.90 ±3.383)days were significantly lower than those in non-electrophysiological group(7.10 ±2.887 days).The hospitalization cost of electrophysiological group(30795.10 ±4589.134)yuan was significantly lower than that of non-electrophysiological group(35758.03 ±5625.984 yuan).Conclusion The curative effect of MVD of HFS and the incidence of postoperative complications were not related to the types of facial nerve and peripheral vascular compression judged by MRI.IONM of facial nerve MVD is helpful to protect patients’ nervous function,reduce the incidence of postoperative complications,shorten hospital stay,and reduce medical expenses,thus speeding up postoperative rehabilitation.It is worth popularizing and applying.