Minimally Invasive Microvascular Decompression For The Treatment Of Idiopathic Hemifacial Spasm And The Prevention Of Complications

Objective:Comparison of Minimally invasive microvascular decompression(MVD)foridiopathic hemifacial spasm cure rate and the incidence of complications andto investigate the validity of the Minimally invasive microvasculardecompression in idiopathic hemifacial spasm disease and minimally invasiverole.Method:This study collected Hebei Province People’s Hospital of Neurosurgery,80cases of patients with idiopathic hemifacial spasm consecutive admitted inApril2009to March2012by Professor Qian Tao, which line Minimallyinvasive microvascular decompression in patients with hemifacial spasm40cases of40patients underwent conventional microvascular decompression forhemifacial spasm patients, the cure rate of the comparison of two surgicalmethods, the incidence of common complications, the size of the bonewindow, the incision size, occipital pain and intraoperative hospital stay.Result:1.1.Incision minimally invasive group, an average of4cm, the bone window,an average of2cm, the successful completion of all surgical patients, withoutincreasing the incision and bone window; average6cm incision of the controlgroup, bone window, an average of3cm.2.Minimally invasive group of40patients were found in the blood vessels ofresponsibility, the control group of39patients found that responsibility forvascular.3.The Minimally invasive group:the cure rate:97.5%(39cases), the incidenceof complications:12.5%(5cases), the incidence of occipital pain:2.5%(1cases); control group:90%cure rate(36cases), the incidence of complications: 17.5%(7cases), the incidence of occipital pain:15%(6cases).The differencewas significant.(P＜0.05).4.After minimally invasive group,1patient with an occipital pain, controlgroup,6cases of patients with occipital pain.5.Postoperative efficacy and follow-up: Minimally invasive group after theJune symptoms of complete remission in39patients, the control group inJune after complete remission of symptoms in36cases, two cases of patientswith delayed cure. Follow-up was made in80cases for an average of12months, the shortest1months, the longest35months,no patients withrecurrence.6.Minimally invasive group, mean postoperative hospital stay was7days, aminimum of6days, up to14days; the control group, mean postoperativehospital stay was12days, a minimum of8days, the longest for21day.Conclusion:1.Minimally invasive microvascular decompression Neuroendoscopy assistedkeyhole technology, to make up for the lack of vision of the microscope tube,and improve the surgical field revealed to reduce the responsibility vascularmissing, reducing the organization stretch its treatment of idiopathic partialhemifacial spasm has a high cure rate, the incidence of complications andoccipital pain, low incidence of surgical incision, and small bone window,shorten the postoperative hospital stay,ect.2.Of major complications after minimally invasive microvasculardecompression for treatment of idiopathic facial spasm: a cranial nervedamage, mainly because of nerve damage, nourish the vascular injury,nourish the blood vessels spasm, brain damage, mainly due to excessivetraction caused by cerebral contusion, perforating branches of vascular injurycaused by brain stem hemorrhage, rock vein damage caused by cerebralinfarction or hemorrhage. Joint Neuroendoscopy applications in minimallyinvasive microvascular decompression to avoid excessive traction on thecranial nerves and brain tissue, surgery area exposed clearly to avoid therepeated harassment of the cranial nerves, blood vessels and brain tissue in mild traction, thereby reducing the the incidence of complications.3.Minimally invasive microvascular decompression of nerveendoscope-assisted keyhole microvascular decompression in idiopathichemifacial spasm minimally invasive role in the clinical application of highvalue.