Clinical value of intraoperative neuroelectrophysiological monitoring in microvascular decompression for patients with primary hemifacial spasm
TANG Si-wei
WANG Lei
LU Bin
JIANG Wen-bo
WU Guo-qing
Abstract：Objective To investigate the application value of intraoperative electrophysiological monitoring(IEM)in microvascular decompression(MVD)for patients with primary hemifacial spasm(HFS).Methods The clinical data of 304 patients with primary HFS treated with MVD from January 2012 to September 2022 were retrospectively analyzed.Lateral spread response(LSR),brainstem auditory evoked potential(BAEP)and electromyography(EMG)of the facial nerve were performed in 103 patients during the operation(monitoring group),and did not in 201 patients(control group).Six months after operation,the efficacy was evaluated according to Cohen spasm grading.Complications such as facial paralysis,tinnitus,vertigo and hearing loss were recorded 1 week and 6 months after operation.Results LSR disappeared completely after decompression of the facial nerve in 95 patients,LSR amplitude decreased by＞50％in 7,and LSR amplitude decreased not significantly in 1.The amplitude of wave Ⅰ of BAEP decreased by more than 50％in 2 patients,and the latency of wave Ⅲ increased by more than 20％in 1.Facial nerve EMG was detected in 61 patients(amplitude＜100 µV in 54 patients,100～200 µV in 7).There was no significant difference in the effective rate between the monitoring group(93.03％)and the control group(94.17％;P＞0.05)6 months after operation.One week after operation,the rates of facial palsy(12.43％),tinnitus(13.43％),vertigo(20.40％)and hearing loss(13.43％)in the control group were significantly higher than those(4.85％,5.83％,11.65％,4.85％,respectively)in the monitoring group(P＜0.05).Six months after operation,the rates of tinnitus(8.46％),vertigo(11.44％)and hearing loss(9.00％)in the control group was still significantly higher than those(1.94％,3.88％and 1.94％,respectively)in the monitoring group(P＜0.05);however,there was no significant difference in the incidence of facial palsy between the control group(3.00％)and the monitoring group(1.00％;P＞0.05).Conclusions MVD is effective for primary HFS.The application of IEM can help to identify the responsible vessels,reduce the injury of nerve and brain tissues,and reduce postoperative complications.
Keywords：Primary facial spasmMicrovascular decompressionIntraoperative electrophysiological monitoringEfficacyPostoperative complications
Publication Date：2023-12-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 689-692 )