复发性和持久性半面的病因学和管理 - - 一个单一中心的经验
Mariam Al Mutawa1,2, Marc Matthes2, Henry W S Schroeder2
1Department of Neurosurgery, Jaber Al Ahmad Hospital, Kuwait City , Kuwait.
Neurosurgery
|March 8, 2024
概括
对半面 (Hemifacial spasm,简称HFS) 的微血管减压检查可能会由于Teflon粘附或错过的血管压缩而失败. 避免与特龙的神经接触,并使用内镜检查可以改善复发性HFS病例的结果.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
背景情况:
- 微血管减压 (MVD) 在半面 (HFS) 中非常成功.
- 在MVD后复发或持续的HFS需要修复手术.
- 识别MVD失败的原因对于改善结果至关重要.
研究的目的:
- 调查微血管减压 (MVD) 后复发性半面 (HFS) 的潜在原因.
- 分析导致MVD失败的因素和修复手术的结果.
主要方法:
- 对HFS进行MVD修复的患者的回顾性评估.
- 评估复发原因,手术技术,并发症和结果.
- 对患者人口统计,症状持续时间,成像,手术记录和后续访谈的审查.
主要成果:
- 在493名患者中,43人 (8.7%) 需要修复手术.
- 面部神经的结 (53.5%) 和错过的血管压缩 (30.2%) 是导致失败的主要原因.
- 修复手术在67个月的中位数随访后,在62.8%的患者中导致了完全的解消.
结论:
- 对面部神经的特龙粘附是MVD后HFS复发的重要原因.
- 在没有神经接触的情况下放置Teflon,并使用吊链/桥梁技术,可以防止复发.
- 建议对条骨髓部进行内镜检查,以确定错过的违规血管.
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