Clinical Observation Of Microvascular Decompression On Treatment Of Hemifacial Spasm Combined With Trigeminal Neuralgia

Objective:To investigate the clinical feature and therapeutic efficacy of facial spasm combined with trigeminal neuralgia.To evaluate the efficiency and saferty of microvascular decompression(MVD)in treating hemifacial spasm combined with trigeminal neuralgia,To explore Occurrence regularity of facial spasm combined with trigeminal neuralgia,the common offending vessels,complications and prognosis related with in order to provide evidence-based medicine for the clinical application.Methods:Nineteen cases of patients with hemifacial spasm combined with trigeminal neuralgia were treated in our hospital from Jan.2009 to Jan.2017 were collected.Retrospective analysis were made with these cases in Clinical information imaging examination technique and complication,Reviewed the relevant literature,and summing up of the clinical diagnosis and microsurgical methods and curative effect of this disease.Results:Twelve cases of female,seven cases of male;clinical Course with eight months to six years with an average of 2.52 years,nineteen patients aged from forty-two to sixty-nine with an average age of 56.31.All patients underwent microvascular decompression at the root-entry zone(REZ)of cranial nerves v and vii after neurovascular compression was diagnosed by magnetic resonance tomographic angiograph(MRTA).Vascular compression was noticed in the REZ of trigeminal nerve in 17 cases(vertebral basilar artery in 16,Superior cerebellar artery in 3),while negative exploration in 2 patients.The offending vessels of compression of the REZ of the facial nerves were the vertebral basilar artery in 16 cases,the anterior inferior cerebellar artery in 2 cases and no vascular in 1 case.operative effect:16 cases of trigeminal neuralgia were cured,2 cases were effective,1 case was ineffective and the total effective rate was 94.74%.Recurrences occurred in 2 cases in the follow-up period time.16 cases of facial spasm were cured,1 case was effective,2 cases were ineffective and the total effective rate was 89.47%.Recurrences occurred in 1 case in the follow-up period time.Postoperative complications inclued one case of transient facial paralysis,one case of ipsilateral tinnitus,two case of hearing impairment.The others were recovered smoothly.Conclusion:The common cause of primary hemifacial spasm combined with trigeminal neuralgia is arterial compression.Oppression caused by coiling vertebral basilar artery is likely to be the major cause of facial spasm combined with trigeminal neuralgia.In the treatment of hemifacial spasm combined with trigeminal neuralgia,Microvascular decompression(MVD)is currently the preferred method with the most significant effect.vnoninvasive recognition responsible blood vessels,effectively placed right relief materials is an important guarantee to improve cure rate.