面肌诱发肌电图监测下面肌痉挛微血管减压术

Microvascular decompression operation for hemifacial spasm under the monitoring of facial EMG

目的探讨面肌诱发肌电图监测下,微血管减压治疗面肌痉挛的有效方法。方法21例术中以面肌诱发肌电图监测寻找责任血管,粗大成袢的责任血管以宽带涤纶条抬起固定于硬膜上,术中用罂粟碱生理盐水冲洗神经根部血管及术野。结果17例术后面肌抽搐立即停止,4例6-61d停止。结论微血管减压术中运用面肌诱发肌电图可明确判断责任血管,证实充分减压,评估预后;粗大成袢的责任血管抬起固定可有效地预防复发;术中罂粟碱应用,有利于减少术后并发症的发生。

Objective To investigate the effective method of the microvascular decompression （MVD） operation for hernifacial spasm under monitoring of facial evoked electromyography（EMG） . Methods Of 21 patients with hemifacial spasm, EMG was performed in MVD to find the compressing vessels. The enlargement and ansiform vessels were raised and fixed in the dural by wide Dacron grafts. The blood vessels in facial nerve root and operation field were douched by the saline containing papaverine. Rusults The facial spasm stopped immediately after the operation in 17 cases,stopped from 4 to 61 days in 4 cases. Conclusions EMG was performed in MVD to judge the compressing vessels accurately, and to determine the sufficient decompression and evaluate the prognosis. The enlargement and ansiforrn vessels were raised and fixed to avoid the recurrence effectively. The saline containing in papaverine can decrease the postoperative complication.