Strategies of complex condition in microvascular decompression for hemifacial spasm / 中华神经医学杂志

ABSTRACT

Objective To explore the efficacy of difficult decompression and its influence factors in microvascular decompression for hemifacial spasm.Methods A retrospective analysis of clinical data and follow-up results of 458 patients who underwent microvascular decompression for hemifacial spasm in our hospital from October 2012 to December 2015 was performed.Aecording to whether there was narrow posterior fossa,compression of vertebral artery with perforating branch of brain stem or long vertebral artery,or vessel passing through cranial nerves,all patients were divided into difficult and general decompression groups (n=50,n=408);the effective rate,delayed remission rate and their influencing factors were compared between the two groups.Results All patients were followed up for one to 3 years,averaging 1.6±0.6 years.Among them,46 patients from difficult decompression group were effective (effective rate=92％ [46/50]);and 390 patients from general decompression group were effective (effective rate=95.6％ [390/408]);no statistical difference was noted between the two groups (x2=0.592,P=0.442).But there was statistical difference in delayed remission rate between the two groups (47.8％ vs.25.1％,x2=10.627,P=0.001).Logistic regression analysis was performed among gender,age,course of disease,offending vessels,location,indentation of facial nerve,complex condition of microvacular decompression,efficacy rate and delayed relief rate,and it showed that indentation of facial nerve was related to delayed relief(OR=7.681,P=0.004,95％CI10.235-31.223).Conclusion The hemifacial spasm patients with difficult decompression are able to achieve as good effect as general decompression if measures are used properly,but the delayed relief rate might be high.