| Objective:Facial spasms (hemifacialsPasm, HFS) is a common functional neurologicaldisease, characterized by side facial muscle onset, rhythmic, involuntary twitch. A facialspasm is very difficult to heal. Early symptoms are transient twitch on one side of lid andpatients are generally not too caring about it. Twitch range along with the course of thedisease in patients will extend and expand and more frequent. When twitching for a longtime, such disease can lead to patients with facial deformities. Deeply switch will bringserous impact to patients’ sleeping and rest quality, brings great pain to normal work andfamily life, will unbearable for patients. In order to improve the quality of life, patients tryacupuncture, medication, closed treatment, however, the effect not beautiful, the diseasestill have recurrent case. By microvascular decompression (MVDmicrovaseulardeeompression,) treatment of facial spasm, this article analyze the generallaw of facial spasm, the common responsibility blood vessels, complications andprognosis, and the article illustrate the micro tube decompression is the first choice forfacial spasm. Microvascular decompression is the certain reference to the treatment offacial spasm in the future.Methods:Collect and summary290cases of Liaoning province people’s hospital fromJune2010to May2011; analyze patients’ history of the disease, patient’s age, gender,basic situation and spasms diagnostic norm type. Using microvascular decompressionand combining related literature for treatment; finding out responsibility vascular sourceto analyze cases after healing and complications.Results:Among290cases, the proration of female is64.48%and male is35.52%. Thenumber of Ⅲ level patients with facial spasm is largest, it includes2.41%of level Ⅱ,93.45%of level Ⅲ,4.14%of level Ⅳ. Intraoperative responsibility under the bloodvessels from anterior artery, account for41.03%, cerebellar artery,33.45%in the next after the vertebral artery and combined other blood vessels were13.45%,12.07%morethan other root vascular compression (including3cases not found responsible bloodvessels). Postoperative follow-up of18months, cured271cases (including postoperativeconvulsions immediately disappeared in244cases, delayed heal27patients,6patientshad facial there is still a slight twitch for postoperative spasm symptoms improve,7caseshave no obvious improvement,6cases of postoperative recurrence. The total cure rate is93.4%, improvement rate is2.1%, the overall effective rate is95.5%, no efficiency is2.4%, the recurrence rate is2.1%. Follow-up after surgery and no serious complications,3patients got facial paralysis,21patients had mild tinnitus,13patients hearing loss.Conclusion:Microvascular decompression is the recognized treatment of facial spasmand it’s the effective and safe method;responsibility and relief materials to judge the sizeand placed properly is the key item to influence surgery effect;correct intraoperativenoninvasive exposed cranial nerve roots is an important technical support to reducecomplications.Proficient in micro dissection, intraoperative coordination position andmicroscope’s point of view, as far as possible fully exposed noninvasive facial nerve rootsand noninvasive recognition responsible blood vessels, effectively placed right reliefmaterials is a important guarantee to improve cure rate. Intraoperative responsibilityshould focus on looking for facial nerve vascular brainstem; rich experience, familiarwith micro skills play a key role in reducing severe complications. Serious complicationsreduced gradually these years, it is preference method of most patients. |
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