摘要
目的评价显微血管减压治疗面肌痉挛手术后听力异常的发生原因并探讨预防方法。方法回顾我科自2005年1月~2016年1月收治的54例面肌痉挛患者接受显微血管减压术后发生听力的相关资料。根据临床表现明确诊断,术前排除同侧听力损害,且行影像学检查提示局部血管对面神经根部存在不同程度及类型的压迫。术中结合电生理监测保护神经功能,术后对其听力损害随访并分析可能因素,根据术前患者选择、术中注意事项及术后观察指标等探讨预防方法。结果随访时间1~12年,平均5.8年,本组52例面部抽搐完全消失,2例术后随访过程中抽搐复发;本组患者术后均不同程度出现听力异常表现,如耳鸣、异响、听力下降等,随访结果提示36例痊愈,12例仅轻度缓解,6例无明显缓解,其中低频耳鸣预后较好,而听力下降恢复困难。结论显微血管减压手术是面肌痉挛的有效方法,听力损伤是较为常见术后并发症且部分不可逆,减压方式正确选择及术中规范操作选择可避免此类并发症发生。
Objective To evaluate the causes and treatments of hearing damage following microvascular decompression operation（MVD） for hemi--facial spasm（HFS）. To explore the ef- fective solutions and prevention for the complication. Methods We followed up 54 patients with HFS who received microvascular decompression and developed hearing damage in our department from January 2005 to 2015. The diagnosis was established by clinical feature of all patients,and any hearing loss was excluded before operation. Different vascular compression ways of the root entry zone and facial nerve was found by magnetic resonance imaging scan. Clinical effects and hearing damage were followed up in the study. Neurophysiological monitoring was used in the op- eration tO prevent any injury of the nerve. We also analyzed the probable causes of this complica- tion in both preoperative and postoperative periods. Results A total of 52 cases got rid of the spasm immediately and 2 cases showed no relief of the spasm in the follow--up period （1 ＂-~ 12years,5.8 years on average）. All cases showed various hearing damage as tinnitus, abnormal sound and hearing loss. However , 36 cases recovered and 12 cases only showed slightly recovery. A total of 6 cases remained the complication ind the follow--up period. Tinnitus and abnormal sound turned out to be easier to be cured than hearing loss. Conclusion Microvascular decom- pression is a kind of safe and effective way to cure HFS in long--term follow--ups. Hearing dam- age may be one of the most common side effects of MVD. Proper selection of decompression of re-sponsible vascular may be an effective way to avoid hearing damage.
出处
《立体定向和功能性神经外科杂志》
2017年第1期15-19,共5页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
面肌痉挛
显微血管减压手术
听力损害
Hemi-- facial spasm
Microvascular decompression
Hearing damage
