面肌痉挛显微血管减压术后迟发性面瘫

Delayed facial palsy after microvascular decompression for hemifacial spasm

目的探讨面肌痉挛显微血管减压术（MVD）后迟发性面瘫的病因、治疗及预后。方法随访我院同一个术者自2007年1月至2009年11月行MVD治疗的415例面肌痉挛患者中术后出现迟发性面瘫者,研究面瘫的发生时间、持续时间及预后情况。结果 415例患者中20例术后出现迟发性面瘫,发病率4.8%。面瘫发生时间为术后5－14 d（平均10.7 d）,持续时间为14－150 d（平均49.7 d）;不论是否经过治疗,所有出现迟发性面瘫的患者均能够临床治愈。结论 MVD术后迟发性面瘫并不少见,发病原因尚不明确,可能与疱疹病毒感染有关,具有临床自愈性,预后佳。

Objective To study the etiology,treatment and prognosis of delayed facial palsy（DFP） after microvascular decompression（MVD） for the hemifacial spasm（HFS）.Methods Patients suffered from DFP after MVD were retrospectively studied within 415 patients of HFS from January 2007 to November 2009.Results Of 415 patients,20 patients developed DFP after MVD with an incidence of 4.8%.The onset of palsy occurred at 5-14 d postoperation（average 10.7 d） and the duration of palsy was 14-150 d（average 49.7 d）.All the patients with DFP could achieve complete recovery with or without treatment for palsy.Conclusion DFP after MVD for HFS is not rare.The etiology of DFP is not clear,which may be related to herpes simplex virus infection.Complete recovery of palsy and good prognosis can be achieved even without any special treatment.