肌电图监测在面肌痉挛微血管减压术中的应用

目的 探讨面肌肌电图监测在面肌痉挛微血管减压术（MVD）中的应用价值。方法 回顾性分析MVD治疗的72例面肌痉挛患者的临床资料，术中仔细辨别并处理责任血管，通过实时记录面肌的肌电反应了解减压效果。结果 60例有明确责任血管压迫，6例单纯性蛛网膜粘连或增厚，6例存在隐匿性责任血管。术后异常肌电图波形完全消失54例，基本消失16例，无明显变化2例。术后临床症状完全消失57例，部分消失14例，无改善1例；总有效率为98.6%（71/72）。结论 面肌肌电图监测可实时了解术中减压效果，对面肌痉挛的MVD，尤其是隐匿性责任血管所致面肌痉挛具有重要的指导作用。

Application of EMG monitoring to microvascular decompression for hemifacial spasm

Objective To explore the applied value of intraoperative electromyography (EMG) monitoring to microvascular decompression for hemifacial spasm. Methods The clinical data of 72 patients with hemifacial spasm, who underwent microvascular decompression under intraoperative EMG monitoring, were analyzed retrospectively. The real-time recording of EMG response of facial muscles was performed by the needle electrode put into the ipsilateral orbicularis oculi muscle, orbicularis oris muscle and masseter. Intraoperative careful identification and treatment of vessels responsible for hemifacial spasm in order to understand the effect of decompression and Objectively evaluate the prognoses of the patients. Results The blood vessels responsible for the hemifacial spasm were definitely determined in 60 patients. The arachnoid adhesion or thickening was found in 6 patients. The occult blood vessels probably were the vessels responsible for the hemifacial spasm in 6 patients. The abnormal EMG waveforms completely disappeared in 54 patients, almost disappeared in 16 and were unchanged in 2 after the decompression. The clinical symptoms disappeared completely in 57 patients, partly in 14 and were unchanged in 1 after the decompression. The overall effective rate was 98.6% (70/72). Conclusion The facial EMG monitoring is helpful to the intraoperative evaluation of the effect of decompression on the hemifacial spasm and the prognoses in the patients with hemifacial spasm. EMG monitoring plays an important guiding role in the microvascular decompression for hemifacial spasm, which especially caused by occult blood vessel.