Comparison of treatment efficacies of microvascular decompression in hemifacial spasm patients with recurrent abnormal muscle response and stably disappeared abnormal muscle response
10.3760/cma.j.cn115354-20200814-00650
- VernacularTitle:显微血管减压术治疗面肌痉挛术中AMR复现和AMR稳定消失患者疗效的比较
- Author:
Hongxiang REN
1
;
Li ZHANG
;
Yanbing YU
;
Ge GU
;
Yulian ZHANG
Author Information
1. 国家卫健委中日友好医院神经外科，北京 100029
- Keywords:
Hemifacial spasm;
Microvascular decompression;
Abnormal muscle response
- From:
Chinese Journal of Neuromedicine
2020;19(12):1208-1213
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the treatment efficacy of microvascular decompression (MVD) in hemifacial spasm (HFS) patients with stable disappearance of abnormal muscle response (AMR) and recurrence of AM.Methods:A total of 1705 HFS patients who received MVD and accepted AMR monitoring during the whole process were selected in our hospital from January 2014 to January 2019. According to the intraoperative AMR monitoring results, these patients were divided into AMR stable disappearance group and AMR recurrence group. All patients were followed up for 12-68 months; the delayed cure rate and total cure rate were compared between the two groups.Results:Among the 1158 patients from AMR stable disappearance group, 1086 patients were cured immediately after surgery, 48 were cured within 0.2-3 months of surgery, and 24 patients were not effective. Among the 547 patient from AMR recurrence group, 301 patients achieved immediate cure after surgery, 232 patients had delayed cure in the follow up period (ranged from 0.5 to 6 months), and 14 patients were not effective. The total cure rate showed no significant difference between the two groups (97.9% vs. 97.4%, P>0.05), but the delayed cure rate in patients from AMR recurrence group was significantly higher than that from AMR stable disappearance group (42.4% vs. 4.1%, P<0.05). Re-examination of AMR at the end of surgery showed that AMR disappeared again in 294 patients from the AMR recurrence group without intracranial intervention, and AMR continued to exist in 253 patients at the end of surgery. Conclusion:After complete intraoperative decompression of HFS by MVD, the AMR recurrence does not require immediate re-operative exploration and decompression, which can still ensure excellent curative effect and has a relatively high probability of delayed cure; and the evaluation of its curative effect should be extended to at least one year after surgery.
