锁孔入路微血管减压治疗面肌痉挛的临床研究

目的：探讨面肌痉挛微血管减压治疗的术前评估和手术技巧。方法：选择67例经MRTA检查确认面神经REZ存在责任血管的面肌痉挛患者，采用乙状窦后锁孔入路微血管减压治疗，对比观察术中发现责任血管情况。并随访分析手术疗效。结果：67例术中在面神经REZ均发现了责任血管并进行了充分减压，术后面肌抽搐立即停止37例．2周内停止9例，2个月内停止12例。2例术后轻度面瘫及3例术后耳鸣经对症治疗1周内恢复，1例存留听力下降，无颅内感染等其它并发症。随访3～48个月（平均10个月），1例复发并较术前加重，3例症状改善不佳（抽搐频率减少〈50％）。4例明显改善（抽搐频率减少〉50％），抽搐症状完全消失59例。总体有效率94．O％。结论：微血管减压术是血管源性面肌痉挛有效的治疗方法，术前MRTA评估、术中准确判定责任血管并充分减压有助于提高手术疗效．而责任血管穿行于面听神经之间是影响手术疗效的重要原因之一。

Clinic study of 67 patients with hemifacial spasm by microvascular decompression through keyhole approach

Objective:To study the preoperative evaluation and technique of microvascular decompression(MVD)on hemifacial spasm(HFS).Method:67 cases with idiopathic HFS,which offending vessels identified on MRTA,were treated by MVD with Teflon through key hole retrosigmoid approach.The responsible vascular and therapeutic efficacy were retrospectively and systematically analyzed.Results:All of 67 patients with MVD completed decompression of offending vessels at the root entry zone(REZ)of the facial never were observed....