[1]王晶,种玉龙,戴宇翔,等.双侧椎动脉相关面肌痉挛的手术疗效分析[J].中国临床神经外科杂志,2022,27(10):805-808.[doi:10.13798/j.issn.1009-153X.2022.10.002]
　WANG Jing,CHONG Yu-long,DAI Yu-xiang,et al.Surgical outcomes of hemifacial spasm associated with bilateral vertebral artery compression[J].,2022,27(10):805-808.[doi:10.13798/j.issn.1009-153X.2022.10.002]
点击复制

双侧椎动脉相关面肌痉挛的手术疗效分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年10期
页码:
805-808
栏目:
论著
出版日期:
2022-10-31

文章信息/Info

Title:
Surgical outcomes of hemifacial spasm associated with bilateral vertebral artery compression
文章编号:
1009-153X（2022）10-0805-04
作者:
王晶; 种玉龙; 戴宇翔; 陆天宇; 倪红斌; 梁维邦
210008南京，南京鼓楼医院神经外科（王晶、种玉龙、戴宇翔、陆天宇、倪红斌、梁维邦）
Author(s):
WANG Jing;  CHONG Yu-long;  DAI Yu-xiang;  LU Tian-yu;  NI Hong-bin;  LIANG Wei-bang
Department of Neurosurgery, Nanjing Drum Tower Hospital, Nanjing 210008, China
关键词:
面肌痉挛; 显微血管减压术; 双侧椎动脉; 疗效
Keywords:
Hemifacial spasm;  Microvascular decompression;  Bilateral vertebral arteries;  Outcomes
分类号:
R745.1+2;R651.1+1
DOI:
10.13798/j.issn.1009-153X.2022.10.002
文献标志码:
A
摘要:
目的 探讨双侧椎动脉（BVAs）相关面肌痉挛（HFS）的临床特征及显微血管减压术（MVD）的疗效。方法 回顾性分析2018年1~12月收治的首次行MVD治疗的362例HFS的临床资料。结果 362例中，BVAs相关HFS有16例。责任血管的分布：BVAs合并小脑前下动脉（AICA）有14例，BVAs合并小脑后下动脉（PICA）有1例，BVA合并AICA与PICA有1例。10例（62.5%）BVAs在后组颅神经水平向腹侧无移位空间，8例（50%）对侧椎动脉直径比同侧粗大。术后即刻治愈率为93.6%（15/16），随访2年治愈率为87.5%（14/16）。结论 BVAs相关HFS临床较少见，往往联合AICA或PICA压迫面神经出脑干区，多表现为对侧椎动脉冗长扩张，且在后组颅神经处无移位空间。因血管类型复杂，可采用联合减压方法，疗效较好。术前影像学评估及熟练掌握神经血管解剖特点是手术成功的关键。
Abstract:
Objective To investigate the characteristics and surgical outcomes of hemifacial spasm (HFS) associated with bilateral vertebral artery (BVA) compression. Methods The clinical data of 362 patients with HFS who underwent microvascular decompression (MVD) from January 2018 to December 2018 were analyzed retrospectively. Results Of 362 patients with HFS, 16 patients were BVAs related HFS. The offending arteries including BVAs plus AICA occurred in 14 patients, BVAs plus PICA in 1, and BVAs plus AICA and PICA in 1. In 10 patients (62.5%), there was no movable space to the ventral side on the posterior cranial nerves level. In 8 patients (50%), the contralateral vertebral artery of the symptomatic side was more ectatic, dolichoectatic and tougher than the ipsilateral vertebral artery. The immediate postoperative cure rate was 93.6% (15/16), and the 2-year follow-up cure rate was 87.5% (14/16). Conclusions HFS associated with BVA compression is rare in clinic. The offending arteries usually include BVAs combined with AICA or PICA. Due to the complex type of offending arteries, combined decompression is recommended to achieve good outcomes. Preoperative imaging evaluation and proficiency in neurovascular anatomical characteristics are the key to successful surgery.

参考文献/References:

[1]卓开全，张　用，刘窗溪. 原发性面肌痉挛的诊治进展[J].中华神经外科杂志，2017，33（11）：1185-1188.
[2]孙洪涛，赵万勇，刁云锋，等. 显微血管减压术治疗1576例脑神经疾患的疗效分析[J]. 中华神经外科杂志，2017，33（9）：883-886.
[3]王　强，周　强，夏锡伟，等. 微血管减压术治疗椎动脉相关性面肌痉挛的疗效分析[J]. 临床神经外科杂志，2016，13（5）：364-367.
[4]Jiang CR, Liang WB, Wang J, et al. Microvascular decompression for hemifacial spasm associated with distinct offending vessels: a retrospective clinical study [J]. Clin Neurol Neurosurg, 2020,194: 1-5.
[5]Masuoka J, Matsushima T, Makahara Y, et al. Outcome of microvascular decompression for hemifacial spasm associated with the vertebral artery [J]. Neurosurg Rev, 2016, 40(2): 267-273.
[6]王　晶，杨华堂，赵俊杰，等. 磁共振水成像高分辨序列在血管压迫性面肌痉挛微血管减压术中的应用价值[J]. 中国临床神经外科杂志，2020，25（11）：787-788.
[7]Zhang X, Zhao H, Zhu J, et al. Outcome of biomadical glue sling technique in microvascular decompression for hemifacial spasm involving the vertebral artery [J]. World Neurosurg, 2017, 104: 186-191.
[8]Nonaka Y, Hayashi N, Matsumae M, et al. Wedge-technique for transposition of the vertebral artery in microvascular decompression for hemifacial spasm: technical nuances and surgical outcomes [J]. Acta Neurochir (Wien), 2019, 161: 1435-1442.
[9]Hyuk JC, Seok KC, Bong AR. Microvascular decompression for hemifacial spasm due to four offending vessels: a case report [J]. Turkish Neurosurg, 2013, 23: 241-244.
[10]Shimano H, Kondo A, Yasuda S, et al. Microvascular decompression for hemifacial spasm associated with bilateral vertebral artery compression [J]. World Neurosurg, 2015, 84 (4): 1178.e5.
[11]Wang QP, Yuan Y, Xiong NX, et al. Anatomic variation and hemalynamic evolution of vetebrobasilar arterial system may contribute to the development of vascular compression in hemifacial spasm [J]. World Neurosurg, 2019, 124: E233-E240.
[12]Kim KJ, Kim JM, Bae YJ, et al. The association between vertebrobasilar dolichoectasia and hemifacial spasm [J]. Parkinsonism Relat Disord, 2016, 32: 54-59.
[13]郝　杨，于炎冰，王　琦，等. 显微血管减压术治疗面肌痉挛[J]. 中华神经外科杂志，2017，33（9）：887-891.
[14]许　晖，董江涛，王　惠，等. 神经电生理监测在面肌痉挛显微血管减压术的应用[J]. 中国微侵袭神经外科杂志，2020，25（12）：550-552.

相似文献/References:

[1]杜　浩　黄　河　宋　健　何远志　孙荣辉　丁慧超　姚　顺　徐国政.面肌痉挛微血管减压术后并发症的相关危险因素分析[J].中国临床神经外科杂志,2016,(05):267.[doi:10.13798/j.issn.1009-153X.2016.05.004]
　DU Hao,HUANG He,SONG Jian,et al.Analysis of risk factors related to complications after microvascular decompression in patients with hemifacial spasm[J].,2016,(10):267.[doi:10.13798/j.issn.1009-153X.2016.05.004]
[2]申彦杰　宋　健　成文平　程东亮.微血管减压术治疗面肌痉挛57例[J].中国临床神经外科杂志,2016,(04):238.[doi:10.13798/j.issn.1009-153X.2016.04.016]
[3]黄　进　吴祥奎　张岩松　邵君飞.肌电图监测在面肌痉挛微血管减压术中的应用[J].中国临床神经外科杂志,2016,(03):164.[doi:10.13798/j.issn.1009-153X.2016.03.011]
　HUANG Jin,WU Xiang-kui,ZHANG Yan-song,et al.Application of EMG monitoring to microvascular decompression for hemifacial spasm[J].,2016,(10):164.[doi:10.13798/j.issn.1009-153X.2016.03.011]
[4]曾　冉　王飞红　袁邦清　杨　光　苏同刚.微血管减压术治疗面肌痉挛疗效分析[J].中国临床神经外科杂志,2016,(03):175.[doi:10.13798/j.issn.1009-153X.2016.03.016]
[5]向兴刚　张永辉　李大志　昝向阳　于晓晨　蔡　宁　赵　永　林　琳.神经内镜辅助微血管减压术治疗面肌痉挛疗效分析[J].中国临床神经外科杂志,2015,(10):624.[doi:10.13798/j.issn.1009-153X.2015.10.015]
[6]卫永旭　杨文磊　赵卫国　李　宁　蔡　瑜　濮春华　吴哲褒.肌松药对面肌痉挛微血管减压术中电生理监测的影响[J].中国临床神经外科杂志,2015,(09):526.[doi:10.13798/j.issn.1009-153X.2015.09.005]
　WEI Yong-xu,YANG Wen-lei,ZHAO Wei-guo,et al.Effect of muscle relaxants on lateral spread responses during microvascular decompression for hemifacial spasm[J].,2015,(10):526.[doi:10.13798/j.issn.1009-153X.2015.09.005]
[7]耿　飞.枕下乙状窦后入路微血管减压治疗面肌痉挛的并发症及处理[J].中国临床神经外科杂志,2015,(03):168.[doi:10.13798/j.issn.1009-153X.2015.03.014]
[8]贾　力　傅先明　姜晓峰　牛朝诗　邓大丽　何金超　李仲森　汪业汉.神经电生理监测异常肌反应在面肌痉挛术中的作用[J].中国临床神经外科杂志,2015,(05):262.[doi:10.13798/j.issn.1009-153X.2015.05.002]
　JIA Li,FU Xian-ming,JIANG Xiao-feng,et al.Use of intraoperative electrophysiological monitoring of abnormal muscle response in surgery for hemifacial spasm[J].,2015,(10):262.[doi:10.13798/j.issn.1009-153X.2015.05.002]
[9]余海林　宋业纯　王晓松.单纯表现为面肌痉挛的桥小脑角区胶样囊肿1例[J].中国临床神经外科杂志,2017,(03):138.[doi:10.13798/j.issn.1009-153X.2017.03.003]
[10]王　宁　王　林　陈国强　黄乙洋　焦永辉　郭宇鹏　王晓松.以三叉神经痛和/或面肌痉挛起病的桥小脑角区肿瘤的手术治疗[J].中国临床神经外科杂志,2017,(08):549.[doi:10.13798/j.issn.1009-153X.2017.08.009]
　WANG Ning,WANG Lin,CHEN Guo-qiang,et al.Microsurgery via suboccipital retrosigmoid approach for cerebellopontine angle tumors with onset of trigeminal neuralgia and hemifacial spasm[J].,2017,(10):549.[doi:10.13798/j.issn.1009-153X.2017.08.009]
[11]王文雄　成　睿 综述　张刚利 审校.弥散张量成像辅助面肌痉挛治疗研究进展[J].中国临床神经外科杂志,2020,(05):331.[doi:10.13798/j.issn.1009-153X.2020.05.026]
[12]李东冉,姚安会,任豪,等.绒球下入路微血管减压术治疗面肌痉挛疗效分析[J].中国临床神经外科杂志,2023,28(01):18.[doi:10.13798/j.issn.1009-153X.2023.01.006]
　LI Dong-ran,YAO An-hui,REN Hao,et al.Clinical efficacy and safety of microvascular decom-pression through infrafloccular approach for patients with hemifacial spasm[J].,2023,28(10):18.[doi:10.13798/j.issn.1009-153X.2023.01.006]
[13]张婧,宋启民,程彦昊,等.多模式神经电生理监测在面肌痉挛MVD中的应用[J].中国临床神经外科杂志,2024,29(01):19.[doi:10.13798/j.issn.1009-153X.2024.01.006]
　ZHANG Jing,SONG Qi-min,CHENG Yan-hao,et al.Application of multimodal neuroelectrophysiological monitoring in microvascular decompression for patients with hemifacial spasm[J].,2024,29(10):19.[doi:10.13798/j.issn.1009-153X.2024.01.006]
[14]任坚锋,赵永斌,田杨,等.不同刺激强度下的异常肌反应对面肌痉挛显微血管减压术中操作的指导意义[J].中国临床神经外科杂志,2023,28(10):632.[doi:10.13798/j.issn.1009-153X.2023.10.007]
　REN Jian-feng,ZHAO Yong-bin,TIAN Yang,et al.Significance of abnormal muscle response under different stimulation intensity during microvascular decompression for patients with primary facial spasm[J].,2023,28(10):632.[doi:10.13798/j.issn.1009-153X.2023.10.007]

备注/Memo

备注/Memo:
（2022-06-26收稿，2022-08-12修回）
更新日期/Last Update: 2022-11-30