| ObjectiveThrough the retrospective analysis of 174 HFS patients with MVD to find the key issues of curative effect and complication.Conclusion the privotal matters of MVD so as to improve success rate and reduce the complications.MethodsThe case choose 174 HFS patients cured with MVD in PLA 371 central hospital from 1st.1.2014 to 31 th,12.2015,all those cases were completed with the same operator.Every patient was scanned MRI FLAIR before the operation and cured by MVD.The case record every response vessel and complication,flup within 6months,12 months,18 months and 24 months,find the danger issues and relationship with response vessel and complication.ResultsThe results show that 61 males accounted for 35.1%,113 females accounted for 64.9%,and females obviously have more than males.There are 89 persons whose lesions are located on the left side of the brain,accounted for 51.1%,85 persons left,accounted for 48.9%.Age ranges from 22 to 75 years old,the average age is 54.1±13.2Y.The history ranges from 1year to 20 years,average 5.2±3.6 years.Hospitalization lasts from 8 to 21 days,average for 12.5 days.According patient's condition to reply Cohen classification.Class I 33 cases accounted for 19%,class II39 cases accounted for 22.4%,class III 59 cases accounted for 33.9%,class IV 43 cases accounted for 24.7%.The symptoms gradually worsen from the eyelid to the facial muscles.No case of bilateral spasm.81 persons were accepted Acupuncture and botulinum toxin blocking therapy before the operation,accounted for 46.4%.Among them,21 patients had facial paralysis before operation,29 patients had hearing loss before operation.The patients underwent MRI FLAIR scanning before operation,and not found CPA tumor.All patients were primary hemifaicial spasm.According to the MRI,22 cases were vertebral artery(CA)type,accounted for 12.6%;41 cases were VA and VICA,accounted for 23.6%;13 cases were VA and PICA,accounted for 7.5%;62 cases were AICA,accounted for 35.6%;22 cases were PICA,accounted for 12.6%;11 cases were Branches of anterior inferior cerebellar artery,accounted for 6.3%;3 cases were not obvious vessel of responsibility,accounted for 1.7%.No venous vascular compression was found.The above results are consistent with the findings of surgical procedure exploration.143 surgical results were completely effective,accounted for 82.2%;22 surgical results were partially effective,accounted for 12.6%;9 results were invalid,accounted for 5.2%.156 patients who were completely effective ones were visited 6 months later.The success rate of operation was 90%;160 patients who were completely effective ones were visited 18 months after operation,the success rate of operation was 93.7%;164 patients who were completely effective ones were visited 24 months after operation,the success rate of operation was 94.3%.Postoperative complications occurred in 58 patients,accounted for 33.3%.21 of them were facial paralysis,accounted for 36,2%;24 of them were hearing loss,accounted for 41.4%;8 of them were cerebrospinal fluid leak,accounted for 13.8%;5 of them were poor healing of surgical incision,accounted for 8.6%.None of them occurred intracerebral hemorrhage and central system infection.Patients who were cerebrospinal fluid leak and poor healing cured within 2 weeks.There were 10 peoples who were facial paralysis and 8 patients who had hearing impairment 6 months later;There were 8 patients who were facial paralysis and 13 patients who had hearing impairment 12 months later.There were 7 patients who were facial paralysis and 13 patients had hearing impairment 18 months later,so were 24 months later.Those who were not cured after operation were vertebral artery complex compression.Conclusion1.Different decompression methods should be selected according to different response vessels.VA and multiple response vessels include VA were the key issues for complication and success rate of MVD.2.Acute complications often have badly prognosis.Delayed complication mostly recovered well. |
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