再次面神经根微血管减压手术治疗面肌痉挛的疗效分析  

Re-operation for failed hemifacial spasm after microvascular decompression

作　　者：舒伟[1] 李勇杰[1] 陶蔚[1] 胡永生[1] 张晓华[1] 王海澎[1] 朱宏伟[1] 

机构地区：[1]首都医科大学宣武医院功能神经外科,北京100053

出　　处：《立体定向和功能性神经外科杂志》2017年第1期11-14,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨面神经微血管减压手术无效或复发的原因,分析再次手术预后。方法回顾性分析2010年1月至2016年1月首都医科大学宣武医院功能神经外科收治的既往手术无效或复发的面肌痉挛患者临床资料。17例患者均再次行面神经根微血管减压手术,术后采用Park YS量表评估疗效,随访大于12个月。结果17名患者的首次手术失败原因包括责任血管遗漏8例(47.1%)、责任血管压迫未充分减压1例(5.9%)、垫棉因素8例(47.1%)。再次手术后疗效优秀16例(94.1%),疗效中等1例(5.9%),术后出现脑脊液漏1例、短期面瘫3例。结论面神经微血管减压手术失败常与责任血管遗漏和垫棉相关,再次手术有效、安全。Objective To analyze the failure cases of microvascular decompression and dis- cuss the outcome of the re--operation. Methods From January 2010 to January 2016,17 patients with failed HFS underwent repeat MVD surgery in the department of functional neurosurgery of Xuanwu Hospital of Capital Medical University. Primary outcome measure was Park YS grade at 12 months. Results Of 17 surgical patients, the causes of failed surgery were offending vessels missing （47. 1%）, inadequate decompression （5.9%） and Teflon factor （47. 1%）. 16 （94. 1%） patients＂ symptoms disappeared, 1 （5.9%） patient＇s symptom reduced. Of 4 complications,3 pa- tients had short--term facial paralysis and 1 patient had cerebrospinal fluid fistula. Conclusion Failed HFS,whose common causes are Vascular and Teflon,could be treated by repeat MVD ef- fectively and safely.

关 键 词：面肌痉挛 微血管减压术 复发 再次手术 

分 类 号：R745.1[医药卫生—神经病学与精神病学]