Correlation Between Vascular Compression Of The Brainstem Portion Of The Facial Nerve And Hemifacial Spasm Effect

Purpose To explore the significance of the brainstem portion in facial nerve microvascular decompression,improve the curative effect of hemodialysis microvascular decompression,reduce postoperative complications.Metheod A retrospective analysis was used to collect primary hemifacial spasm(HFS)who underwent facial nerve microvascular decompression from January 2012 to December 2015.All patients underwent facial nerve microvascular decompression(MVD),180 patients who reminds exsist LSR after entire microvascular decompression were divided into three groups according to the different surgical methods: There were 58 cases in the whole decompression group,vascular compression in the cisternal portion,placed the gasket;There were 52 cases in the nerve combing group,no vascular compression in the cisternal portion,only sort out the facial nerve;There were 70 cases in the brainstem portion decompression group,do not probe cisternal portion,only decompression the brainstem portion.All the surgery were the same surgery to complete;three groups of patients were routinely routine MRA examination,excluding cerebellopontine angle tumors and other secondary factors.All cases of facial nerve microvascular decompression were treated with posterior hernia sinus approach,the facial nerve intracranial segment is divided into two areas,respectively,brainstem portion(BP)and cisternal portion(CP).lateral spread response(LSR)、brainstem auditory evoked potential(BAEP)were performed in the two groups.The differences of intraoperative anatomy,electrophysiological changes,surgical curative effect and complication were compared between the two groups.Results 1.There was no statistically significant difference in the responsibility of blood vessels between the groups.2.There was no significant difference in the degree of compression between groups.3.There was no statistically significant difference between the groups in the disappearance of LSR.Whether the LSR has completely disappeared has nothing to do with the brain segment.4.BAEP abnormal changes in the difference between the groups were statistically significant,indicating that operation in the cisternal portion will increase the abnormal changes in BAEP.5.At the end of the operation,the recovery of BAEP between the groups was statistically significant,indicating that operation in the cisternal portion will decreased the recovery of BAEP.6.Postoperative efficacy,the formation was not statistically significant,indicating that the efficacy of simple brainstem portion decompression and no difference between the whole decompression.7.In the hearing loss,delayed facial paralysis and dizziness,the difference between the groups was statistically significant.Indicating that simple brainstem portion decompression can reduce postoperative complications.Conclusion 1.Brainstem portion of the facial nerve and the occurrence of hemifacial spasm is closely related to the critical parts of the neural vascular conflict.2.MVD surgery to release the brainstem portion of the facial nerve vascular compression can achieve satisfactory surgical results.3.Simple brainstem portion MVD can effectively reduce postoperative complications.