Clinical Observation And Meta-analysis Of Endoscope-assisted Microvascular Decompression In The Treatment Of Hemifacial Spasm

Objective: To investigate the role of endoscope in microvascular decompression in the treatment of hemifacial spasm.Methods: Part I: Collect all patients with hemifacial spasm from January 2018 to August 2021.83 patients were selected according to the inclusion and exclusion criteria.According to the operation method,50 people were divided into endoscope-assisted microvascular decompression group(observation group)and 33 people were divided into microscope microvascular decompression group(control group).The detection rate of offensive blood vessels,the effective rate and perioperative complications rates were compared between the two groups.Part II:Retrieving the study of microvascular decompression in the treatment of hemifacial spasm according to the principles and methods of evidence-based medicine,and further systematically evaluating the effectiveness and safety of endoscope-assisted in the treatment of hemifacial spasm through meta-analysis.Results: Through the case-control study,the detection rate of offensive blood vessels(98.00%)and the effective rate(96.00%)in the observation group were higher than those in the control group(81.00%)(P < 0.05).There was no significant difference in the total incidence of complications between the two groups(P > 0.05).A total of 10 studies involving 1344 patients were included for meta-analysis in our study.The effective rate of the observation group was higher than that of the control group(OR= 4.77,95% CI: 2.95-7.70,P < 0.00001).The total incidence of complications in the observation group was lower than that in the control group(OR=0.29,95% CI: 0.13-0.64,P = 0.002).Subgroup analysis showed that the detection rate of offensive blood vessels in the observation group was higher than that in the control group(OR= 5.99,95% CI: 2.18-16.45,P = 0.0005),and the incidence of dysaudia in the observation group was lower than that in the control group(OR= 0.26,95% CI:0.15-0.47,P < 0.00001).There was no significant difference in postoperative facial paralysis,tinnitus,and intracranial infection between the two groups.Conclusion: 1.Microvascular decompression is an effective method for the treatment of hemifacial spasm.2.The offensive blood vessels can be better identified by endoscopic observation during operation.3.The combined application of neuroendoscopy can improve the effective rate and reduce the incidence of complications.