A Comparative Analysis Of The Efficacy And Safety Of Neuroendoscope And Microscope MVD In The Treatment Of Hemifacial Spasm

Objective:To compare and analyze the difference in efficacy and safety of neuroendoscopic surgery and traditional microscope surgery for hemifacial spasm,discuss and evaluate the value and application prospect of MVD in the treatment of hemifacial spasm under complete neuroendoscopy,it hopes to provide a reference for the selection of the best surgical procedure for the surgical treatment of patients with hemifacial spasm in the future.Methods:A retrospective analysis of the clinical data and follow-up data of 58 patients with primary hemifacial spasm who received MVD treatment from January 2017 to December 2019 in the Department of Neurosurgery,Gansu Provincial People’s Hospital.among them,25 cases were operated under complete endoscope as endoscope group,and 33cases were treated with traditional microscope decompression as microscope group.The effective rate and the incidence of postoperative complications(facial paralysis,hearing impairment,tinnitus,hoarseness and cough,diplopia,vertigo and disturbance of balance,cerebellum and brain stem injury,cerebrospinal fluid leakage,intracranial hemorrhage,intracranial infection,etc.)and the length of operation,Blood loss during the operation and Length of hospital stay after operation were compared between the two groups.Results:Compared with the two groups,there was no significant difference in the postoperative effective rate(X~2=0.055,P=0.815),recurrence rate(P=0.495),total complication rate(X~2=0.411,P=0.522)and the incidence of complications(facial paralysis,hearing impairment,tinnitus,vertigo and balance disorder,diplopia,intracranial infection)between the endoscope group and the microscope group,There were statistical differences in operation time(t=3.338,P=0.002)between the neuroendoscopy group and the microscope group.The operation time of the endoscopic group was longer than that of the microscope.However,there was no significant difference between the two in terms of intraoperative blood loss(t=-0.744,P=0.460)and postoperative hospital stay(t=-0.936,P=0.353).Conclusion:1.There is no significant difference between the endoscopic group and the microscope group in terms of postoperative efficacy and complication rate.2.Complete endoscopic MVD treatment of hemifacial spasm is safe and feasible,with higher effective rate and lower complications after surgery.