神经电生理监测下显微手术治疗老年原发性面肌痉挛

Application of intraoperative neuroelectrophysiological monitoring in the microsurgery decompression for hemifacial spasm in elderly patients

目的探讨术中电生理监测指导微血管减压术治疗老年原发性面肌痉挛的手术疗效。方法回顾性分析19例老年原发性面肌痉挛病人的临床资料,均经枕下乙状窦后入路行微血管减压手术,术中监测异常肌电反应,随访分析术后疗效。结果19例病人均顺利度过围手术期,治愈18例,部分治愈1例。所有病人术后随访1~4年,治愈率为94.7%,有效率为100%,未见复发病例。结论老年原发性面肌痉挛经手术治疗可取得满意效果,术中应用神经电生理监测可评价手术疗效。

Objective To explore the efficacy of intraoperative electrophysiological monitoring in microvascular decompression（MVD）for hemifacial spasm in elderly patients. Methods Clinical data of 19 old patients with hemifacial spasm were analyzed retrospectively,who underwent MVD via suboccipital retrosigmoid approach. The abnormal muscle responses were monitored and the efficacy was analyzed by follow-up. Results All the patients successfully underwent the perioperative period. Complete cure was achieved in 18 patients and partial cure in 1. All the patients were followed up for 1 to 4 years, the cure rate was 94.7% and the total efficiency rate was100%. No relapse was found. Conclusion Old patients with hemifacial spasm can achieve satisfactory results by MVD and surgical outcome can be evaluated by intraoperative neuroelectrophysiological monitoring.