BAEP在面神经显微血管减压术中的应用

The application of BAEP in patients with hemifacia spasm receiving micorvascular eecom- pression

目的：评价脑干听觉诱发电位（BAEP）在面肌痉挛（HFS）患者行显微血管减压术（MVD）术前及术后检测中的应用价值。方法：收集54例HFS患者行面神经MVD术前及术后7d复查的BAEP检测数据，对主要波形成分波峰潜伏期（PL）、峰间期（IPL）、波幅差异、V波反应阈值等结果进行对比分析。结果：54例术前患侧BAEP指标异常27例（50％）；其中2例因诊断脑干梗死而未行手术。52例术后与术前患侧对比明显异常改变者2例，其余患者术前与术后各测值比较P值均〉0．05，差异无统计学意义；术前患侧耳不同程度听力障碍者14例（27％），术后复查保持术前听力者50例，听力下降者2例，并发症发生率为4％。结论：BAEP检测有助于评估及判定HFS患者行MVD术前及术后脑干听觉通路传导状况。对排查高风险患者，提高手术安全系数及客观反映听神经受损等并发症的发生等具有较高的临床应用价值。

Objective：To evaluate the value of brainstem auditory evoked potential （BAEP） in patients with hemifacial spasm （HFS） before and after micorvascular decompression （MVD）. Methods： BAEP was performed in 54 patients with HFS who received MVD of facial nerve before and 7 days after surgery. The potential latency （PL）, interpeak potential latency （IPL）, amplitude and reaction threshold of wave V were compared and analyzed. Results：There were 27 patients （50 % ） with abnormal BAEP be- fore MVD in 54 patients and 2 patients （4%）with obvious change of BAEP before and after surgery. There was no statistical difference between wave I , wave III, wave V of PL before and after MVD in other patients （P〉O. 05）. There were 14 patients （270/40） with impaired hearing of different degree in the affected side before MVD. The hearing examination after surgery indicated that 50 patients had no hearing change and hearing decrease in 2 patients（4%）. Conclusion：BAEP is helpful to evaluate the auditory pathway in patients with HFS before MVD. It is of clinical value for BAEP to screen the patients with high risk, improve surgery safety, and reflect the surgery complications such as impaired auditory nerves objectively.