微血管减压术治疗面肌痉挛复发原因分析

目的 探讨微血管减压术治疗面肌痉挛后症状复发的原因。方法 对19例经微血管减压术治疗后症状消失1年以上，痉挛又复出现的患者行二次手术。术中发现所有病例均因第一次手术时减压棉片放置位置不当和/或大小不适，致责任血管复位而重新压迫面神经根部。二次手术中将责任血管游离后推移离开面神经根部，用Teflon棉进行固定。结果 二次手术后18例症状消失，1例减轻。第二次术后所有病例经1．2～7年随访，平均3．8年，除1例仍有轻度痉挛外，余症状均消失。结论 微血管减压术是治疗面肌痉挛的有效方法，准确判断责任血管并实施有效的减压是提高手术效果、减少症状复发的关键。

The analysis of the reasons of recurrence of hemifacial spasm after microvascular decompression

Objective To study reasons of recurrence of hemifacial spasm(HFS)after microvascular decompression(MVD).Method The reoperative MVD were performed in 19 HFS patients with recurrence after the first MVD.During which improper insertion of decompressing grafts and improper choose of grafts size were the main reasons of recurrence.The compressing vessels were removed from the facial nerve root exit zone (REZ) and fixed by Teflon grafts.Result The symptoms of HFS disappeared after the second MVD in 18 cases and was reduced in 1. There was no recurrence during follow-up period(1.2-7 years,mean 3.8 years).Conclusion MVD is an effective microsurgical method for treating HFS.Accurate judgement of compressing vessels and proper decompression are the keys to improve surgical effectiveness and decrease recurrence rate.