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Szu-Yen Pan¹, Chih-Ming Lai^1,2, Chih-Wei Huang^1,3

¹1Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.

Neurosurgical focus

|September 1, 2025

概括

在半面中成功进行微血管减压 (MVD) 时,不需要完全消除横向扩散反应 (LSR). 显著减少LSR幅度,特别是在脑筋肌肉,准确地预测了有利的结果.

科学领域:

神经外科
神经生理学
医疗技术

背景情况:

半面 (Hemifacial spasm,简称HFS) 是一种神经疾病,表现为面部肌肉的非自愿收缩.
微血管解压 (MVD) 是一种通过减轻头骨神经压力来治疗HFS的手术.
在MVD期间使用内科神经生理监测 (IONM),包括横向扩散反应 (LSR) 评估.

研究的目的:

确定在HFS患者中完全消除LSR是否对MVD成功至关重要.
确定一个量化手术内生物标志物,预测HFS的MVD后的良好结果.

主要方法:

对208名接受MVD初级HFS的成年患者进行了回顾性分析.
在手术期间进行神经生理监测 (IONM),从三个面部肌肉中进行LSR记录.
使用机器学习模型计算LSR的最终与基线幅度变化比率 (FBCR).

主要成果:

在心肌 (96. 2%) 和耳骨 (92. 3%) 肌肉中最常见的LSR.
完整的LSR消失并不需要改善或完全解决结果.
心肌FBCR≥86. 5%预测完全解脱 (CR) 准确率为88%;FBCR≥48. 5%预测临床改善 (CI) 准确率为98%.

结论:

完全消除LSR并不是HFS中MVD成功的前提.
在LSR幅度的定量降低,特别是在脑筋肌肉,作为一个可靠的内科预测结果.
在HFS手术中建议采用肌肉特异性,值驱动的IONM方法.

关键词:

不正常的肌肉反应面部面部在手术期间进行神经生理监测侧向扩散反应微血管减压

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