锁孔入路微血管减压术治疗62例原发性面肌痉挛的临床分析

Clinical analysis of Keyhole microvascular decompression in treatment of 62 patients with primary hemifacial spasm

目的：探讨锁孔入路微血管减压术对原发性面肌痉挛的疗效。方法：回顾性分析经锁孔入路微血管减压术治疗的62例原发性面肌痉挛患者的临床资料。62例患者术前均行磁共振血管断层成像（MRTA）检查确定受压迫血管。结果：术后面肌痉挛立即消失54例,1周内消失2例,1个月内消失3例,3个月内消失2例,半年内消失1例。随访1~2年,复发1例。术后发生脑脊液漏2例,迟发性面瘫2例,听力下降3例。结论：锁孔入路微血管减压术治疗原发性面肌痉挛安全、创伤小、有效率高,可作为原发性面肌痉挛的首选治疗方法。

Objective： To explore the curative effects of Keyhole microvascular decompression for hemifacial spasm （HFS）. Methods： Sixty-two patient were performed microvascular decompression via retrosigmoid approach. Compressing vessels were determined by MR tomographic angiography （ MRTA ） in preoperative assessment. The patients were followed up for 1 to 2 years. Results： HFS stopped immediately after the operation in 54 patients, 1 week in 2 patients, 1 month in 3 patients, 3 months in 2 patients and 6 months in 1 patient. HFS recurred in 1 patient during 1-2 years followed up. Two patients had leakage of cerebrospinal, 2 patients delayed facial paralysis, 3 patients hearing loss. Conclusion： Microvascular decompression via retrosigmoid approach have good efficacy in treatment of HFS and is safe, minimally invasive. It may be the first choice for treatment of HFS.