CAJ | 학술논문

目的探讨非典型性面肌痉挛的发病机制和手术治疗方法.方法回顾性分析2005年7月到2010年7月采用显微血管减压术治疗的36例面肌痉挛病例,临床表现均为非典型性发作.结果 32例患者术后面肌痉挛立即消失,4例患者术后痉挛减轻但未消失,随访5个月时完全消失.随访12-72个月,平均42个月,延迟治愈者4例(11％),无复发病例.术后发生并发症6例(17％),包括中度面瘫、听力下降3例,听力下降伴耳鸣3例;随访期间均好转.结论非典型性面肌痉挛患者神经受血管压迫位置一般位于面神经出脑干区的远侧端,采用显微血管减压术可获良效,但术后发生面瘫、听力障碍的概率升高.术中责任血管的准确识别、实时脑干听觉诱发电位监测、避免颅神经和细小血管的损伤,有助于提高疗效、减少并发症的发生.
목적 탐토비전형성면기경련적발병궤제화수술치료방법.방법 회고성분석2005년7월도2010년7월채용현미혈관감압술치료적36례면기경련병례,림상표현균위비전형성발작.결과 32례환자술후면기경련립즉소실,4례환자술후경련감경단미소실,수방5개월시완전소실.수방12-72개월,평균42개월,연지치유자4례(11％),무복발병례.술후발생병발증6례(17％),포괄중도면탄、은력하강3례,은력하강반이명3례;수방기간균호전.결론 비전형성면기경련환자신경수혈관압박위치일반위우면신경출뇌간구적원측단,채용현미혈관감압술가획량효,단술후발생면탄、은력장애적개솔승고.술중책임혈관적준학식별、실시뇌간은각유발전위감측、피면로신경화세소혈관적손상,유조우제고료효、감소병발증적발생.
Objective To study the pathogenesis and surgical treatment of atypical hemifacial spasm.Methods The clinical data of 36 patients who underwent microvascular decompressions (MVD) for atypical hemifacial spasm(HFS)from July 2005 to July 2010 were retrospectively analyzed.Results The HFS disappeared immediately after MVD in 32 patients.The postoperative spasm was weaker in 4 patients and the residual spasm was disappeared within 5 months.There was no reoccurrence of spasm during follow -up period.The postoperative complications included:transient moderate facial paralysis accompanied with hearing dysfunction in 3 cases,and transient hearing dysfunction accompanied with tinnitus in 3.Conclusions Atypical hemifacial spasm is caused by vessels on the posterior rostral side of facial nerve.The effectiveness could be predicted after MVD.But the rates of facial paralysis and/or hearing loss are relatively higher.The rates of complications could be reduced significantly by correct identification of offending vessels,fewer disturbance to cranial nerves,avoiding the injury to the penetrating vessels,and intraoperative brain stem auditory evoked potential monitoring during.