| Objective:To analyze the influencing factors of delayed cure in patients with hemifacial spasm after microvascular decompression.Methods:The clinical data of patients with facial spasm who underwent microvascular decompression in our hospital’s neurosurgery department from October 2018 to October 2021 were retrospectively analyzed.The patients were followed up for 1-2 years after surgery.They were divided into delayed cure group and immediate cure group according to the time of remission of postoperative spasm symptoms.The influencing factors of delayed cure after surgery were analyzed and the prediction model was constructed.Results:Of the 226 patients,175 were cured immediately,33 were delayed,5 were significantly relieved,3 were partially relieved,2 were ineffective,and 3 were recurrent.The delayed cure rate was 14.9%,and the total effective rate was 96.4%.The influencing factors of delayed cure of MVD in HFS patients include course of disease,severity of preoperative symptoms,degree of vascular compression during operation and disappearance of AMR.The nomogram is drawn according to the results of multifactor regression analysis,and the area under the curve(AUC)is 0.882,with high prediction accuracy.Conclusion:The course of disease,the severity of preoperative symptoms and the degree of intraoperative vascular compression are all risk factors for delayed cure after MVD surgery.The disappearance of intraoperative AMR wave indicates that intraoperative decompression is sufficient and usually indicates immediate cure after surgery.For patients with incomplete remission of postoperative spastic symptoms,the efficacy should be evaluated after more than 1 year of observation. |
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