| Objective To observe efficacy of CT-guided radiofrequency ablation(RFA)of facial nerve for primary hemifacial spasm(HFS)and to analyze the factors related to early recurrence after operation.Methods The clinical data of patients with primary HFS who were treated with CT-guided RFA of facial nerve in the Pain Department of the Affiliated Hospital of Jiaxing University from August 2018 to September 2022 were collected.Periodic follow-up visits were conducted after the operation,and the results were recorded to evaluate the effect.Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of early recurrence after operation.The Kaplan-Meier curves of effective rate changing with time under the influence of different conditions were drawn.Results Among 125 patients we collected,the excellent effect rate was 85.6%and the good effect rate was 14.4%.Postoperative complications included mild facial paralysis71.2%,abnormal sensation on the operative side 5.6%,tears on the affected side 5.6%,dry eyes on the affected side 2.4%,transient pain at the puncture point(yawning)2.4%,and abnormal sensation on the affected side with cheek swelling 1.6%.The median effective time of CT-guided RFA of facial nerve for primary HFS was 12 months,95%CI:10.66-13.34,and the effective rates in 3,6,9 months,respectively were 95.2%,76.0%and 49.7%.Postoperative House-Brackmann(HB)grade and age were the influencing factors of early recurrence.Compared with HB-Ⅰ.the risk of early recurrence about HB-Ⅱ(OR=0.109,95%CI:0.037-0.320,P<0.001)and HB-Ⅲ(OR=0.019,95%CI:0.002-0.156,P<0.001)decreased significantly.In comparison with the older group,the youngers had a higher risk of early recurrence(OR=3.871,95%CI:1.30411.490,P<0.05).HB-Ⅰ(median effective time:6 months,95%CI:5.363-6.637);HB-Ⅱ(median effective time:14 months,95%CI:11.718-16.282).HB-Ⅲ(median effective time:16 months,95%CI:14.395-17.605),and there were significant differences between groups(log-rank P<0.001).Age≤59 years old(median effective time:9 months,95%CI:8.607-11.393);age>59 years old(median effective time:15 months,95%CI:12.964-17.036),the difference between the two groups was statistically significant(log-rank P<0.001).Conclusion CT-guided RFA of facial nerve for primary HFS is an effective and minimally invasive treatment for primary HFS,which can improve the spasm symptoms of facial muscles in patients.Age and postoperative HB grade are independent influencing factors of early recurrence. |
