Clinical analysis of microvascular decompression under neuroendoscope for hemifacial spasm

Ma Hongyuan; Li Guang; Li Yongjun; Liang Zhihui

doi:10.11850/j.issn.1009-122X.2024.11.002

Abstract：Objective:To investigate the prognosis of microvascular decompression (MVD) under neuroendoscope in the treatment of hemifacial spasm (HFS) and its impact on facial spasm status and hearing levels of patients. Methods The clinical data of 94 HFS patients were analyzed retrospectively,who were divided into two groups based on surgical methods:the conventional MVD group (conventional group,n=33) and the neuroendoscopic MVD group (endoscopic group,n=61). The clinical efficacy,surgical indicators (intraoperative blood loss,operative duration,and length of hospital stay),HFS frequency,hearing levels,quality of life (assessed using the hemifacial spasm-8 scale,HFS-8),and complications and recurrences were compared between the two groups. Results Compared with the conventional group,the endoscopic group had a higher total response rate after 12 months of follow-up,with lower intraoperative blood loss and shorter operative duration and length of hospital stay (all P<0.05). Compared with preoperative levels,the HFS frequency and HFS-8 scores decreased in both groups after 6 months of follow-up,with the endoscopic group showing lower values compared to the conventional group. The hearing levels in the endoscopic group were higher than those in the conventional group (P<0.05). During the follow-up period,the incidence of complications in the endoscopic and conventional groups was 9.84％ and 18.18％,respectively,with no statistically significant difference between the two groups (P>0.05). After 12 months of follow-up,there were no recurrences in the endoscopic group,while the recurrence rate in the conventional group was 12.12％,with a statistically significant difference between the two groups (P<0.05). Conclusions Neuroendoscopic MVD offers advantages such as shorter operative duration and less intraoperative blood loss. It can effectively improve HFS status in HFS patients,reduce the impact on their hearing levels,thereby effectively enhancing clinical efficacy and reducing recurrences,with a good safety.