乙状窦后锁孔显微血管减压术治疗面肌痉挛

Hemifacial Spasm Treated by Microvascular Decompression Through Retrosigmoid Key Hole Approach

目的探讨乙状窦后锁孔显微血管减压术治疗面肌痉挛的手术方法和效果。方法12例面肌痉挛患者行显微血管减压术。采用乳突后发际内小切口,小骨窗入颅,寻找和判断责任血管,将责任血管从面神经出脑干区分离,置入Teflon棉絮减压。术后记录手术效果和并发症,出院后进行电话随访。结果责任血管为迂曲的小脑前下动脉、小脑后下动脉或椎动脉,12例患者术后面肌痉挛立即消失;随访至术后3个月,遗有轻度耳鸣、听力下降1例,轻度眩晕1例,无面肌痉挛复发。结论乙状窦后锁孔显微血管减压术治疗面肌痉挛治愈率高、创伤小,远期并发症少。

Objective To investigate surgical methods and efficacy of microvascular decompression for treatment of hemifacial spasm through retrosigmoid key hole approach. Methods Twelve cases of hemifacial spasm underwent microvascular decompression in our hospital. Postmastoid approach were used. Identified offending vessels firstly, then displaced them away from the root exit zone of facial never by interposing teflon graft between offending vessels and brain stem. The treatment efficacy and complications were recorded in followed up for 3 months.＇Results Offending vessels were identified as anteroinferior cerebellar artery, posteroinferior cerebellar artery or vertebralartery. Spasm symptom disappeared after microvascular decompression in all ca- ses. There left mild tinnitus and auditory acuity decrease in 1 case,mild vertigo in 1 case. No reoccurrence occured. Conclusion Microvascular decompression through retrosigmoid key hole approach had good efficacy in hemifacial spasm treatment, with advantages of high cure rate and less long term complication.