The Value Of Intraoperative Neurophysiological Monitoring In Hemifacial Spasm

ObjectivesTo evaluate the value of LSR、BAEP、Facial-MEP in Hemifacial Spasm.MethodsWe study the patient retrospectively.Unmonitoring groups:84cases in theControl Group, pure MVD, cases of facial spasm are from August2009to August2010,.80cases in the monitoring Group, MVD+neural electrophysiologicalmonitoring, they come from cases of facial spasm from September2010to August2011, LSR, BAEP and Facial-MEP were monitored, they are also known as theMonitoring Group in the following passages; counting and analyzing effects of twogroups case, the rate of hearing changes，as well as the relationships between LSRand Postoperative effects; BAEP and postoperative hearing changes; Facial-MEP andthe postoperative early facial paralysis in Monitoring period.Results95%patient’effect is very good and5%patient’effect is good in monitoringgroup after pos-operation7days. After1year98.7%is very good and1.3%is good.In un-monitoring group69.1%patient’effect is very good,22.6%patient’effect isgood and22.6%is general. After1year90.5%is very good,8.3%is good and1.2%is general. The effect of two groups has statistically significant in different period.When the muscle relaxant fades away by the monitoring of TOF，all80patients inmonitoring groups have LSR. Sixty-one patients’LSR disappear moment whoseeffect are very good after pos-operation7days and don’t reappear after1years.Sixteen disappear delayed，among which fifteen patients’effect are very good；Oneis good but into good after3months，no recurrence after1years.Three disappear incompletely，but whose volatility all is decreased，effect is good.Among1is intovery good after3months，1is into very good after6months，1has been good.96.3%patient’ hearing is not change,2.5%decreased slightly,1.2%decreasedmoderately after pos-operation7days in monitoring group. After1year98.7%patient’ hearing is not change,1.3%decreased slightly.In un-monitoring group84.5%patient’ hearing is not change,11.9%decreased slightly,2.5%decreasedmoderately,1.1%decreased severe after pos-operation7days. After1year91.75%patient’ hearing is not change,5.9%decreased slightly,1.3%decreasedmoderately,1.1%decreased severe.The hearing of two groups has statisticallysignificant in different period.There are76cases whose BAEP don’t ring,hearing is not change. There are4cases whose BAEP rings.Among1patient’s hearing is not change.2patient’s hearingdecreased slightly,but they return to normal respectively After3months、6months.1patient’s hearing decreased moderately and does not return to normal after1years.The facial nerve function is not change compared to the pre-operation in twogroups. Facial-MEP of monitoring group don’t ringConclusions1.LSR can be used as a Prognosis evaluation index；2.LSR’use can improve early efficacy，reduce delay-cure rate.3.BAEP’use can reduce hearing damage in MVD.