Re-operation for persistent hemifacial spasm after microvascular decompression with the aid of intraoperative monitoring of abnormal muscle response

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• 作者：Shiting Li (1)
  Wenyao Hong (1)
  Yinda Tang (1)
  Tingting Ying (1)
  Wenchuan Zhang (1)
  Xinyuan Li (1)
  Jin Zhu (1)
  Jun Zhong (1)
  Xuming Hua (1)
  Shunqing Xu (1)
  Liang Wan (1)
  Xuhui Wang (1)
  Min Yang (1)
  Yi Li (1)
  Xuesheng Zheng (1)
  
• 关键词：Hemifacial spasm ; Microvascular decompression ; Abnormal muscle response
• 刊名：Acta Neurochirurgica
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：152
• 期：12
• 页码：2113-2118
• 全文大小：171KB
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• 作者单位：Shiting Li (1)
  Wenyao Hong (1)
  Yinda Tang (1)
  Tingting Ying (1)
  Wenchuan Zhang (1)
  Xinyuan Li (1)
  Jin Zhu (1)
  Jun Zhong (1)
  Xuming Hua (1)
  Shunqing Xu (1)
  Liang Wan (1)
  Xuhui Wang (1)
  Min Yang (1)
  Yi Li (1)
  Xuesheng Zheng (1)
  
  1. Department of Neurosurgery, XinHua Hospital, Shanghai JiaoTong University School of Medicine, 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China
  

文摘

Background and objectives Microvascular decompression (MVD) is the only solution that can effectively control hemifacial spasm (HFS). Regarding treatment of the patients who failed the first operation, it is still controversial. We tried to evaluate the safety and efficiency of the early re-exploration for such kinds of patients. Methods Thirteen patients failed the first MVD and received a second MVD procedure. The spasm was not resolved at all or became even more severe after the first MVD. Abnormal muscle response (AMR) persisted during the first MVD operation or disappeared once but emerged again. The patient had a strong will to do the re-operation and was aware of the high risks of operative complications. Results All the 13 patients got good or excellent spasm resolution immediately after the re-operation, which involved whole-range exploration and intraoperative AMR monitoring; however, there were two cases (15.4%) of permanent facial weakness and three cases (23.0%) of transient facial weakness. Conclusions Our experience on early repeat MVD is whole-range exploration and intraoperative AMR monitoring; in other words, re-operation cannot rely too much on experience.