The Effect Analysis Of Perioperative Application Of Nimodipine On Complications After Microvascular Decompression For Primary Hemifacial Spasm

Objective:Hemifacial spasm performs as unilateral facial involuntary twitching.Retrosigmoid approach microvascular decompression is preferred for surgical treatment of hemifacial spasm.But because of the complex anatomy of cerebellopontine angle,in most cases,the responsible vessels walk through the facial nerve and other vessels,some even twisting together,making it easy to cause irritation or damage while pulling or separating the vessel,leading to the occurrence of postoperative complications,such as headache,dizziness,hearing loss,facial paralysis,etc.Nimodipine can prevent vascular smooth muscle cells from contraction,relieve vasospasm,and promote the establishment of collateral circulation.Observe the effect of perioperative application of nimodipine on complications after microvascular decompression for primary hemifacial spasm and used statistical methods to analyze whether it has significant difference.Methods:Totally 90 cases of HFS underwent MVD in our hospital from January 2014 to October 2016 were randomly divided into both the treatment and control groups,45 cases each.There was no significant difference between the two groups in age,gender,course of disease,etc.All patients were unilateral disease,MRI examination was done to clarify diagnosis and exclude space occupying lesions.There’s no hearing disorder,dizziness,headache,facial paralysis or other symptoms among the patients.Each group receives the same conventional therapy.Besides,Nimodipine was given to the treatment group during the perioperation period.Continuous intravenous infusion nimodipine by 0.8mg/h the day before the surgery and the last 4 days,then take oral nimodipine tablets by 60 mg Q4h for 2 weeks instead.The postoperative complications were compared between both the groups by following up for at least 6 months.Results:82 patients were cured immediately after operation,the immediate effective rate was 91.1%,and the rest were significantly improved.5 patients were cured within 7 days after the operation,and the other 3 patients disappeared during the follow-up of 1-3 months.Total effective rate was 100.0%.In the treatment group,11 cases got fever after operation,12 got headache,7 got dizziness,2 got delayed facial paralysis,4 got hearing disorder,1 got cerebrospinal fluid leakage.In the control group,12 cases got fever after operation,14 got headache,15 got dizziness,8 got delayed facial paralysis,11 got hearing disorder,1 got cerebrospinal fluid leakage.None got intracranial infection or brain stem infarction.Except for 1 case in the control group left with mild tinnitus,the others’ complications were recovered by the end of the follow-up.The degree of complications and recovery time of the treatment group were significantly better than those of the control group.Conclusion:1,Microvascular decompression shows satisfactory curative effect and high safety in the treatment of primary hemifacial spasm.2,Perioperative application of nimodipine can reduce the incidence of complications such as dizziness,hearing disorder,and delayed facial paralysis after MVD,and shorten the recovery time.3,Perioperative application of nimodipine had no significant effect on postoperative complications such as fever,headache and cerebrospinal fluid leakage.