Analysis Of The Curative Effect Of Microvascular Decompression With The Aid Of Neuroelectrophysiological Monitoring In The Treatment Of Hemifacial Spasm Relapse

Objective Micro vascular decompression(MVD)has become the most effective treatment for hemifacial spasm(HFS)due to its good curative efficacy,high safety,and its ability to completely preserve nerve and vascular functions.However,there are still some patients who experience post-operation Symptoms recurrence.For patients with recurrence of HFS,MVD is a more effective treatment method.The judgment of the responsible blood vessel during the operation,the adequate decompression of the facial nerve root-out-brainstem area(REZ),the size and placement of the cotton pad,etc.,affect the effect of the operation.It is an important factor,and the difficulty of the second operation will be increased due to local arachnoid adhesion and unclear anatomical relationship,and the incidence of postoperative hearing impairment will also greatly increase.The main reason for postoperative hearing impairment is the damage to the auditory nerve during the operation.Or it nourishes blood vessels.This article explores the effectiveness,practicability and safety of using neuroelectrophysiological monitoring to assist MVD in the treatment of recurrent HFS for comparative research,so as to provide a comparison for whether this technology can further improve the cure rate of relapsed HFS and reduce the incidence of postoperative complications.Reliable evidence-based basis.Methods From January 2015 to January 2020,among all patients with hemifacial spasm treated by the Department of Neurosurgery of Hangzhou First People’s Hospital,the clinical data of patients who had relapsed after MVD treatment in our hospital or outside hospitals were selected as experimental data,A total of 115 eligible patients were screened out.In 2018,our department introduced neuro-electrophysiological monitoring technology.From January 2018 to January 2020,46 cases of MVD treatment assisted by neuro-electrophysiological monitoring were used as the monitoring group,and traditional MVD was used from January 2015 to December 2017 The 69 treated patients served as the control group.115 patients undergoing surgery were followed up for a period of 12 to 36 months,with an average follow-up of 30 months.The postoperative curative effect,postoperative hearing loss and other complications were evaluated.Results Postoperative efficacy:The immediate effective rate of postoperative treatment for 46 patients in the monitoring group was 93.5%,2 cases(4.3%)had partial relief of symptoms,and 1 case(2.2%)had no significant relief of symptoms compared with preoperatively.The effective rate of 69 patients in the control group was 79.7%,10 patients(14.5%)had partial relief of symptoms,and 4 patients(5.8%)had no significant relief of symptoms.Postoperative hearing loss:46 patients in the monitoring group had no postoperative hearing loss in 44 cases(95.7%),1 case had mild hearing loss(2.2%),1 case had moderate hearing loss(2.2%),and no severe postoperative hearing loss.And cases of severe hearing loss.In the control group of 69 patients,there was no postoperative hearing loss in 56 cases(81.2%),8 cases of mild hearing loss(11.6%),4 cases of moderate hearing loss(5.8%),and 1 case of severe hearing loss(1.4%).Cases of severe hearing loss after surgery.Other postoperative complications:In the monitoring group,3 cases(6.5%)of delayed facial paralysis occurred in 46 patients in the monitoring group,8 cases(17.4%)of vertigo,and 9 cases(19.6%)of tinnitus.The 69 patients in the control group had delayed facial paralysis in 5 cases(7.2%),dizziness in 13 cases(18.8%),and tinnitus in 15 cases(21.7%).The analysis results showed that the effective rate of postoperative treatment in the monitoring group was significantly higher than that of the control group.The incidence and degree of postoperative hearing damage in the monitoring group were significantly lower than that of the control group.There was no significant difference in the incidence of other postoperative complications.Conclusion For patients with hemifacial spasm recurrence after MVD surgery,the use of neuroelectrophysiological monitoring for the second MVD surgery is more efficient than traditional MVD surgery,and the incidence and degree of postoperative hearing damage is lower.Therefore,neuroelectrophysiological monitoring assisted microvascular decompression is a safer and more effective method for the treatment of recurrent hemifacial spasm.