Clinical Observation And Meta-analysis Of Neuroendoscope-assisted MVD In The Treatment Of Hemifacial Spasm

Background: microvascular decompression(MVD)is an effective surgical method for hemifacial spasm(HFS)and is the only treatment for the etiology.Postoperative invalidity and postoperative complications are still a difficult problem for clinicians.The neuroendoscopic characteristics of high illumination,wide field and local magnification have certain advantages in the treatment of CPA lesions.Studies have shown that endoscopic adjuvant treatment of HFS can improve postoperative efficiency and reduce the incidence of complications.Objective: comparing the efficient treatment,complications and recurrence rate,endoscope assisted HFS and pure microscope HFS after the difference of the judging nerve for the treatment of endoscope assisted MVD HFS clinical curative effect,and collect the related documents;The efficacy and safety of endoscopic assisted and simple microscopy(MVD)for HFS were evaluated by Meta analysis.Methods: through retrospective study and follow-up of patients with HFS who were treated with all MVDs at Qingdao municipal hospital between October 2012 and October 2017 in Qingdao Municipal Hospital,37 cases of endoscopy-assisted and 41 cases of microscopic groups were selected according to inclusion and exclusion criteria.And in the Cochrane Library,Pub Med,Medline,Embase,Chinese biomedical literature database,Chinese hownet database,weipu database on the database retrieval neural endoscopic assisted and microscope for HFS control study of relevant literature,screening after the use of statistical software Review Manager5.3.Analysis.Results: the operative efficiency in endoscopy assisted group and microscopy group was significantly higher than that in the microscope group.There was no statistically significant difference between the endoscopic assisted group and the postoperative recurrence rate of the microscope group(2=1.613,P=0.204>0.05).There was no statistically significant difference between the endoscopic group and the microscopy group in postoperative neurological dysfunction(chi-2 =0.940,P=0.332>0.05),cerebrospinal fluid leakage(2=0.914,P=0.339>0.05),and intracranial infection(2=2.275,P=0.132>0.05).In the meta-analysis,z-test showed that Z=5.84(P=0.000<0.05),indicating that the difference between the endoscopic auxiliary group and the microscope group was statistically significant.Conclusion: the endoscopic-assisted group was more effective after surgery than the microscope group in the treatment of HFS.There was no significant difference in the incidence of postoperative complications between microscopy group and endoscopy group.Through meta analysis,it can be seen that the endoscopic auxiliary group has higher postoperative curative rate than the microscope group.