乙状窦后入路微血管减压术治疗面肌痉挛

目的探讨面肌痉挛病因及微血管减压术对面肌痉挛的治疗效果。方法126例面肌痉挛患者全部在局麻下行乙状窦后入路面神经根微血管减压术。结果126例患者术中均发现面神经根部有血管压迫．其中小脑前下动脉及其分支51例．小脑后下动脉及其分支38例．椎动脉23例．多根小动脉14例。85例患者术后面肌痉挛即停止．28例于术后7～30天内面肌痉挛停止，8例30～90天内面肌痉挛停止．5例3～6个月内面肌痉挛停止。随访108例，随访时间1～4年。2例于术后16个月复发，2例术后18个月复发。本组无死亡病例。结论面肌痉挛是由于面神经根受血管压迫所致．乙状窦后入路面神经根微血管减压术是治疗面肌痉挛安全有效的方法。

Treatment of hemifacial spasm with retrosegmoid approach microvascular decompression

Objective To explore the causes of hemifacial spasm and the curative effects of retrosegmoid approach microvascular decompression on it.Methods A total of 126 patients (75 male,51 female),with a disease course ranging from 6 months to 10 years,was enrolled in the study,of whom 65 had facial spasm on the left side and 61 on the right side.Retrosegmoid approach microvascular decompression was performed in all the patients.Results Vascular compression in the facial nerve roots was found in all the 126 patients,which included anterior inferior cerebellar artery and the branch compression in 51 cases,posterior inferior cerebellar artery and the branch compression in 38 cases,vertebral artery compression in 23 cases,and small artery compression in 14 cases.Hemifacial spasm stopped immediately after the operation in 85 patients,7 to 30 days after the operation in 28 cases,30 to 90 days after the operation in 8 patients and 3 to 6 months after the operation in 5 patients.Of the 108 patients followed up (time ranging from 1 to 4 years),2 had recurrence 16 months after operation and another 2 had recurrence 18 months after operation.Conclusion Hemifacial spasm is caused by the vascular compression in the facial verve roots,thus,retrosegmoid approach microvascular decompression is safe and effective.