Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko · 2010
[Long-term results of microvascular decompression in treatment of hemifacial spasm].
Аннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Shulev Iu A, Trashin A V, Gordienko K S, Posokhina O V
Аннотация
BACKGROUND: Aim of the study was to assess results of treatment and quality of life of patients with hemifacial spasm (HFS) after microvascular decompression and to analyze intraoperative data in surgical revision of intracranial portion of facial nerve.
MATERIALS AND METHODS: The study included 30 patients with HFS who underwent microvascular decompression. Duration of symptoms varied between 1 and 30 years (mean--6.7 years). Typical manifestation of spasm was observed in 28 cases, atypical--in 22. Severity of HS and its influence on everyday activity were assessed using 5-grade scale (by E. Tan), and surgical results--according to degree of clinical improvement combined with evaluation of quality of life using scale HFS-7. RESULTS. Most frequent type of conflict observed in the series was contact between facial nerve and AICA (64.4%). Compression of facial nerve root entry zone was revealed in vast majority of cases (93.3%), and in 2 patients (6.7%) site of compression was distal to the root entry zone. In a female patient with secondary HFS due to the tumor relations of neurovascular structures were altered and their displacement produced conflict between AICA loop and facial nerve. In our series hearing depression of different severity was observed in 16.7% of patients. This disorder is persistent and does not regress in the follow-up period. All other symptoms of cranial nerve dysfunction are amenable to resolve within 1-2 months.
CONCLUSION: Microvascular decompression of facial nerve is pathogenetically feasible and effective method of treatment of HFS. It allows achievement of consistent regression of symptoms and improvement of quality of life of patients with HFS.
MATERIALS AND METHODS: The study included 30 patients with HFS who underwent microvascular decompression. Duration of symptoms varied between 1 and 30 years (mean--6.7 years). Typical manifestation of spasm was observed in 28 cases, atypical--in 22. Severity of HS and its influence on everyday activity were assessed using 5-grade scale (by E. Tan), and surgical results--according to degree of clinical improvement combined with evaluation of quality of life using scale HFS-7. RESULTS. Most frequent type of conflict observed in the series was contact between facial nerve and AICA (64.4%). Compression of facial nerve root entry zone was revealed in vast majority of cases (93.3%), and in 2 patients (6.7%) site of compression was distal to the root entry zone. In a female patient with secondary HFS due to the tumor relations of neurovascular structures were altered and their displacement produced conflict between AICA loop and facial nerve. In our series hearing depression of different severity was observed in 16.7% of patients. This disorder is persistent and does not regress in the follow-up period. All other symptoms of cranial nerve dysfunction are amenable to resolve within 1-2 months.
CONCLUSION: Microvascular decompression of facial nerve is pathogenetically feasible and effective method of treatment of HFS. It allows achievement of consistent regression of symptoms and improvement of quality of life of patients with HFS.