电生理监测在原发性面肌痉挛微血管减压术中的应用价值

Role of electrophysiological monitoring during microvascular decompression for primary hemifacial spasm

目的探讨术中电生理监测在原发性面肌痉挛微血管减压术中的应用价值。方法行面神经微血管减压术的原发性面肌痉挛患者101例分为两组:A组45例,术中未行电生理监测;B组56例,术中行电生理监测。比较两组即刻手术效果和术后当日不良反应。结果 B组术后当日有效55例(98.2%),发生面瘫4例(7.1%),无眩晕,听力下降2例(3.6%)。A组术后当日有效37例(82.8%),发生面瘫9例(20.0%),眩晕6例(13.3%),听力下降7例(15.6%)。B组手术效果优于A组,眩晕发生率低(P<0.05)。结论面神经微血管减压术中实施电生理监测能提高面神经减压的效率,减少眩晕并发症的发生。

Objective To evaluate the role of electrophysiological monitoring during microvascular decompression for primary hemifacial spasm. Methods A total of 101 patients with primary hemifacial spasm underwent facial nerve microvascular decompression, of whom 56 cases （group B） received electrophysiological monitoring and 45 cases（group A ） did not during surgery. The immediate surgical efficacy and adverse responses on the 1st day after operation were compared. Results In group A,the effectiveness rate was 82.8%（37 cases） and the adverse responses on the 1st day after operation included facial paralysis in 9 cases（20. 0%）, dizziness in 6 cases（13.3%） and hearing loss in 7 cases（15.6%） ,which in group B were 98. 2%（55 cases） and in 4 cases（7.1%） ,in 0 （0%） and in 2 cases（3.6%）, respectively. The effectiveness rate was higher and the incidence of dizziness was lower in group B than those in group A （P〈0. 05）. Conclusion Intraoperative electrophysiological monitoring during microvascular decompression for primary hemifacial spasm is beneficial to improving the immediate surgical efficacy and reducing the occurrence of dizziness after operation.