侧方扩散反应监测在面肌痉挛微血管减压术中的应用

目的 探讨侧方扩散反应（LSR）监测在面肌痉挛（HFS）微血管减压术（MVD）中的应用价值。方法 回顾性分析2016年6月至2018年8月MVD治疗的70例HFS的临床资料，术中均监测LSR。术后1周、1年根据Cohen分级评估术后疗效，0级为治愈。结果 70例均监测到LSR，其中LSR消失65例（消失组），确认充分减压后LSR仍持续存在5例（未消失组）。术后1周，消失组治愈率[92.3%（60/65）]明显高于未消失组[40.0%（2/5）；P<0.05]。术后1年，消失组治愈[96.9%（63/65）与未消失组[80.0%（4/5）]无统计学差异（P>0.05）。结论 MVD治疗HFS，术中监测LSR可以帮助确定责任血管，尽可能减少责任血管的遗漏；术中LSR消失提示近期疗效较好，但对长期疗效的预测价值有限。

Application of lateral spread response monitoring in microvascular decompression for patients with primary hemifacial spasm

Objective To investigate the value of lateral spread response (LSR) monitoring in microvascular decompression (MVD) for the patients with primary hemifacial spasm (pHFS). Methods The clinical data of 70 patients with pHFS who underwent MVD under guidance of LSR monitoring from June 2016 to August 2018 were analyzed retrospectively. One week and one year after the operation, the effectiveness was evaluated according to the Cohen classification and the patients with Cohen level 0 were cured. Results LSR was detected in all the patients. The LSR was disappeared in 65 patients during the operation (disappeared group) and did not in 5 patients (non-disappeared group). One week after the operation, the cured rate of the disappeared group [92.3% (60/65)] was significantly higher than that [40.0% (2/5)] of the non-disappeared group (P<0.05). One year after the operation, there was no statistical difference in the cured rate between the disappeared group [96.9% (63/65)] and the non-disappeared group [80.0% (4/5); P>0.05]. Conclusions For the patients with HFS undergoning MVD, intraoperative LSR monitoring can help determine the responsible vessels and minimize the omission of responsible vessels. The disappearance of intraoperative LSR indicates that the short-term efficacy is better, but its predictive value of the long-term efficacy is limited.