Clinical characteristics and aeromedical evaluations of flying personnel with hemifacial spasm:a retrospective analysis

ZHANG Guangyun; LI Wenping; ZHAO Mengjiao; YANG Fen; ZHAO Cong; CAO Yuhong

doi:10.3969/j.issn.2097-1753.2024.05.002

Abstract：Objective To retrospectively analyze the clinical features and aeromedical evaluations of aircrews with hemifacial spasm(HFS)based on hospitalized cases in Air Force Medical Center and related literature in order to provide references for the treatment and aviation medical identification of HFS in pilots.Methods Using a retrospective study,the electronic case retrieval system of the Air Force Medical Center in the space of 2008-2021 and medical literature databases(from 1970 to December 2021)were searched for cases or clinical research reports of HFS in flight personnel.The general condition,data on flight,clinical manifestations,treatments,prognosis,and aviation medical identification results of the retrieved HFS patients in flight personnel were analyzed and summarized.Results Eight cases with HFS were found in this study,including 6 pilots,1 correspondent,and 1 machinist ages 27 to 55.Three of these cases were asymptomatic and the rest were symptomatic.Three asymptomatic cases were assessed as qualified for flight by an aeromedical evaluation.One symptomatic case treated with microvascular decompression was given waiver consideration and three symptomatic cases treated with carbamazepine were given flight disqualification due to persistent symptoms.The other one experienced symptom relief without treatment and was given flying qualification.Conclusion Visual interference,eye irritation,tears,difficulties in reading and driving caused by HFS in pilots will pose a threat to flight safety.The HFS clinical scale can help to accurately evaluate the flight risk of HFS,and microvascular decompression surgery should be recommended as the optimal treatment for HFS in pilots with blood vessels accompanying facial nerves displayed on magnetic resonance imaging.Flight risks should be assessed in conjunction with the clinical symptoms,therapies and outcomes.