面肌痉挛显微血管减压术后后组颅神经麻痹的预后及影响因素分析

Prognosis and influencing factors of lower cranial nerve palsy after microvascular decompression in patients with hemifacial spasm

目的探讨显微血管减压术治疗面肌痉挛术后患侧后组颅神经麻痹的发生率、患者预后及其影响因素。方法回顾性收集航空总医院神经外二科自2014年5月至2016年8月由同一术者行显微血管减压术治疗的1033例面肌痉挛患者的临床资料,总结术后患侧后组颅神经麻痹的发生率及患者预后情况,并采用统计学方法分析其影响因素。结果1033例面肌痉挛患者中,10例(0.97%)发生术后患侧后组颅神经麻痹,其中6例表现为单独声音嘶哑,2例表现为单独吞咽困难,2例同时具有声音嘶哑和吞咽困难症状。该10例患者中,6例的症状在1个月内恢复,2例在1~3月恢复,2例在3~6个月恢复,均未出现永久性声音嘶哑或吞咽困难。后组颅神经麻痹组(n=10)与非后组颅神经麻痹组(n=1023)间年龄、性别、病程、病变侧别及责任血管类型比较差异均无统计学意义(P>0.05)。结论后组颅神经麻痹是显微血管减压术治疗面肌痉挛术后的少见并发症,责任血管类型并非该并发症的影响因素。

Objective To evaluate the incidence,prognosis and influencing factors of lower cranial nerve palsy after microvascular decompression(MVD)in patients with hemifacial spasm(HFS). Methods Clinical data of 1033 patients with HFS,admitted to our hospital from May 2014 to August 2016,were retrospectively analyzed.The incidence of lower cranial nerve palsy after procedure and prognosis of these patients were summarized;and influencing factors were analyzed by statistical method. Results In 1033 patients with HFS,10 patients(0.97%)had lower cranial nerve palsy after procedure:6 patients suffered hoarseness,2 patients suffered dysphasia,and 2 patients were with both symptoms;the symptoms in 6 patients completely recovered within one month,2 patients within one-3 months,and 2 patients within 3-6 months.No permanent low cranial nerve palsy occurred.There were no statistical significances in age,gender,clinical course,sides,or the types of offending vessels between the lower cranial nerve palsy patients(n=10)and the non-palsy patients(n=1023)(P>0.05). Conclusion Lower cranial nerve palsy is a rare complication after MVD,and type of responsible vessels is not a influencing factor in this complication.