内窥镜辅助下显微神经血管减压术治疗特发性偏侧面肌痉挛

Endoscopic neurovascular decompression for the treatment of idiopathic hemifacial spasm.

目的为进一步提高神经血管减压术治疗特发性偏侧面肌痉挛的疗效。方法经乙状窦后小骨窗开颅加用内窥镜辅助显微血管减压术治疗特发性偏侧面肌痉挛３５例。结果术后３４例症状消失，１例症状减轻，３５例随访６个月至３年半，术后面肌抽搐消失者３３例，１例症状减轻，１例１年后复发。结论内窥镜可弥补手术显微镜的不足之处，减少组织损伤和判断错误，提高治疗效果。

Objective To improve the efficacy of idiopathic hemifacial spasm with neurovascular decompression. Methods Thirty five cases of idiopathic hemifacial spasm were treated with endoscopic neurovascalar decompression by reaching the cerebellopontine angle (CPA) through a small retrosigmoid bony window. A 30° or 70° endoscope was put on the anterior (ventral) and superior(top side) sides of distal part of facial nerve, then, its root entry zone(REZ) was exposed. After gentelly seperating the compression vessel from the nerve root, a small piece of muscle was inserted between the nerve and the vessel. Results All the patients were followed up for 6 months to 3.5 years after the operatively, 33 cases were free of the symptom,spasm was markedly diminished in one case and one case had recurrences of the symptom in one year postoperatively. Conclusions It was suggested that endoscopic neurovascular decompression can remedy some shortcoming of the operation microscope, decrease tissues damage, and improve the cure rate.