Application of neuroelectrophysiological monitoring in microvascular decompression for primary hemifacial spasm

WANG Feng-wei; YANG Jin-qing; XUE Yong

doi:10.13798/j.issn.1009-153X.2019.08.011

Abstract：Objective To investigate the efficacy and safety of microvascular decompression under neuroelectrophysiological monitoring in the treatment of primary facial spasm. Methods The clinical data of 47 patients with primary facial spasm who underwent microvascular decompression through suboccipital retrosigmoid approach from October 2015 to October 2018 were analyzed retrospectively. The introperative neuroelectrophysiological monitorings of brainstem auditory evoked potentials (BAEP) and lateral spread response (LSR) were used in 25 patients (monitoring group) and did not used in 22 patients (control group). Results The LSR waves were induced in all 25 patients before operation, and LSR wave disappeared in 2 after dural incision, disappeared in 1 when cerebellopontine angle cistern was opened, disappeared in 19 after decompression with Teflon cotton sheet, the amplitude decreased significantly in 2 patients, and did not disappear after operation in 1. Intraoperative BAEP monitoring showed that the amplitudes of waves Ⅰ, Ⅲ and Ⅴ decreased, and the latency of waves Ⅰ, Ⅲ and Ⅴ prolonged. There was no significant difference in the total effective rate between the monitoring and control groups (100.0% vs. 95.5% ; P>0.05). The incidence of postoperative complications in the monitoring group (4.0%) was significantly lower than that (18.2%) in the control group (P<0.05). The postoperative recurrence rate in the monitoring group (0% ) was significantly lower than that (9.1% ) in the control group (P<0.05). Conclusion Electrophysiological monitoring during microvascular decompression of primary facial spasm is helpful to reduce the incidence of complications and the recurrence rate.