面神经微血管减压术后并发症分析及治疗

目的：探讨面肌痉挛微血管减压术（MVD）后并发症的原因、预防措施及预后。方法：对笔者所在医院2009年3月-2011年3月行MVD治疗的54例面肌痉挛患者进行1年以上的随访，观察相关并发症的发生、发展及转归情况。结果：12例（22．2％）术后出现不同程度面瘫，其中3例为迟发性面瘫，5例（9．3%）出现轻度听力下降，2例（3．7％）出现耳鸣，1例（1．9%）颅内感染，3例（5．6％）出现皮下积液，1例（1．9％）复视，本组无脑脊液漏及死亡病例，随访1-3年，面瘫及听力下降者全部恢复，1例复视于术后2周自愈，1例仍有耳鸣并出现进展性听力下降。结论：面瘫、耳鸣、听力下降及皮下积液是MVD主要症状，面瘫、耳呜、听力下降及皮下积液多可以恢复或部分恢复，耳聋为远期并发症，术中注意操作技巧，术后给予适当的治疗可有效预防并发症发生。

Facial Nerve Decompression Microvascular Complications Analysis and Treatment

Objective： To study the microvascular decompression for hemifacial spasm （ MVD ） after the causes of complications, prevention and prognosis. Methods： The author＇s Hospital from 2009 March -2011March MVD therapy in 54 patients with hemifacial spasm patients over 1 years of follow-up, observation of associated complications, development and prognosis.Results：12 cases （22.2%） occurred after operation in different degrees of facial paralysis, including 3 cases of delayed facial paralysis, 5 cases （9.3%） showed a mild hearing loss, 2 cases （3.7%） tinnitus in 1 cases （1.9%）, intracranial infection, 3 patients （5.6%） developed subcutaneous effusion, 1 cases （1.9%） diplopia in this group, there was no cerebrospinal fluid leakage and deaths, followed up for 1- 3 years, paralysis and hearing loss were all recovered, lcases with diplopia in patients after 2 weeks to heal, 1 patients still have tinnitus and progressive hearing loss.Conclusion： Facial paralysis, tinnitus, hearing loss and subcutaneous effusion is MVD main symptoms, facial paralysis, tinnitus, hearing loss and subcutaneous effusion can be recovered for long term complications, deafness, intraoperative attention to operative technique, postoperative given appropriate treatment can effectively prevent complications.