Curative Effect Analysis Of The Posterior Ear Transverse Incision Microvascular Decompression For Treatment Of Trigeminal Neuralgia And Facial Spasm

Objective:Compare the differences between the posterior ear transverse incision and ear inclined vertical incision microvascular decompression in the treatment of trigeminal neuralgia and facial spasm,the operation time,postoperative therapeutic effect,postoperative complications,and postoperative hospitalization days,in order to provide more choices for the doctors to select appropriate treatment plan in clinical work.Methods:The clinical data were collected for MVD of treatment of trigeminal neuralgia and facial spasm from 92 cases of patients in Neurosurgery,First Hospital of Jilin University from January 2015 to December 2017,and analyzed the operation time,postoperative therapeutic effect,postoperative complications,and postoperative hospitalization days undergoing two different operation ways(the posterior ear transverse incision and ear inclined vertical incision)using statistical methods,and the pros and cons of two different surgical methods were compared.Results:1.The average operation time required for the posterior ear transverse incision group of 44 patients with trigeminal neuralgia was 2.11 h,and the average operation time required for the ear inclined vertical incision group with trigeminal neuralgia was 3.26 h.Among the 48 patients with facial spasm,the posterior ear transverse incision group needed the average operation time of 2.36 h,and the ear inclined vertical incision group needed the average operation time of 3.06 h.The difference between two groups was statistically significant(P<0.05).Further more,the operation time needed for the posterior ear transverse incision group was obviously less than the ear inclined vertical incision group.2.The effective rate of the posterior ear transverse incision group of the trigeminal neuralgia was(12/13)92.3%,and the effective rate of the ear inclined vertical incision group was(29/31)93.6%.Among the patients with the facial spasm,the effective rate of the posterior ear transverse incision group was(10/11)90.9%,and the effective rate of the ear inclined vertical incision group was 89.2%(33/37).There was not statistically significant in the difference of postoperative therapeutic effect between the two groups(P>0.05).3.On the postoperative complications,the posterior ear transverse incision group of the trigeminal neuralgia was(8/13)61.5%,and the ear inclined vertical incision group was(19/31)61.3%.The posterior ear transverse incision group of the facial spasm was(4/11)36.4%,and the ear inclined vertical incision group was(17/37)46.0%.There was not statistically significant in the difference of postoperative complications between the two groups(P>0.05).4.The average day of postoperative hospitalization required for the posterior ear transverse incision group of 44 patients with trigeminal neuralgia was 9.85 d,and the average day of postoperative hospitalization required for the ear inclined vertical incision group was 12.68 d,which indicated that the difference was statistically significant(P<0.05).The average day of postoperative hospitalization required for the posterior ear transverse incision group of 48 patients with facial spasm was 10.36 d,and the average day of postoperative hospitalization required for the ear inclined vertical incision group was 11.05 d,showed that there was no statistically significance(P>0.05).Conclusion:1.For the patient with trigeminal neuralgia or hemifacial spasm,the operation time needed for MVD with the posterior ear transverse incision is shorter than the time needed for MVD with the ear inclined vertical incision.It indicates that the posterior ear transverse incision is better than the ear inclined vertical incision in the operation time.2.In terms of the postoperative therapeutic effect,there was no significant difference between the posterior ear transverse incision and ear inclined vertical incision.3.In terms of postoperative complications,there was no significant difference between the posterior ear transverse incision and ear inclined vertical incision.4.In terms of postoperative hospitalization days,trigeminal neuralgia with the posterior ear transverse incision is better than the ear inclined vertical incision,while there is no significant difference for hemifacial spasm between the posterior ear transverse incision and the ear inclined vertical incision.