{"title":"优化微血管减压手术以改善半面痉挛的治疗效果:对再次手术的分析。","authors":"Zhu Wanchun, Liu Zhenxing, Zhao Hua, Li Shiting","doi":"10.1007/s10143-024-02892-1","DOIUrl":null,"url":null,"abstract":"<p><p>Microvascular decompression (MVD) surgery is an effective curative treatment for hemifacial spasm (HFS). This study aims to establish techniques that may lead to favorable outcomes by analyzing reoperations in patients with persistent or recurrent HFS.Patients who exhibited persistent or recurrent HFS symptoms after prior MVD surgery were identified as candidates for reoperation. Information regarding the reoperations was collected by tracing the entire surgical procedures and peri-operative management. Clinical manifestations and follow-up data were obtained from the hospital records and subsequent visits.Twenty-six patients underwent repeat MVD surgery. Among them, multi-culprit neurovascular compression (NVC) was identified as the primary cause of failure to response to the previous operation in 73.08% of cases. Pure tissue adhesion accounted for 38.46% of cases, while shredded Teflon pledget (STP) shifting was observed in 7.69% of cases. Postoperative outcomes were assessed through revisits and categorized into four groups: excellent (76.92%), good (15.38%), fair (7.69%), and poor (0%). The longest follow-up period exceeded 65 moths.The trans-lateral suboccipital infra-floccular approach provides a better visual field. Examination of entire length of the facial nerve is essential. STP with gelatin sponge implantation is a suitable material for facilitating nerve and vascular positioning and reducing adhesion.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"685"},"PeriodicalIF":2.5000,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Optimized microvascular decompression surgery for improving the results of hemifacial spasm: an analysis of reoperations.\",\"authors\":\"Zhu Wanchun, Liu Zhenxing, Zhao Hua, Li Shiting\",\"doi\":\"10.1007/s10143-024-02892-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Microvascular decompression (MVD) surgery is an effective curative treatment for hemifacial spasm (HFS). This study aims to establish techniques that may lead to favorable outcomes by analyzing reoperations in patients with persistent or recurrent HFS.Patients who exhibited persistent or recurrent HFS symptoms after prior MVD surgery were identified as candidates for reoperation. Information regarding the reoperations was collected by tracing the entire surgical procedures and peri-operative management. Clinical manifestations and follow-up data were obtained from the hospital records and subsequent visits.Twenty-six patients underwent repeat MVD surgery. Among them, multi-culprit neurovascular compression (NVC) was identified as the primary cause of failure to response to the previous operation in 73.08% of cases. Pure tissue adhesion accounted for 38.46% of cases, while shredded Teflon pledget (STP) shifting was observed in 7.69% of cases. Postoperative outcomes were assessed through revisits and categorized into four groups: excellent (76.92%), good (15.38%), fair (7.69%), and poor (0%). The longest follow-up period exceeded 65 moths.The trans-lateral suboccipital infra-floccular approach provides a better visual field. Examination of entire length of the facial nerve is essential. STP with gelatin sponge implantation is a suitable material for facilitating nerve and vascular positioning and reducing adhesion.</p>\",\"PeriodicalId\":19184,\"journal\":{\"name\":\"Neurosurgical Review\",\"volume\":\"47 1\",\"pages\":\"685\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurosurgical Review\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10143-024-02892-1\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurosurgical Review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10143-024-02892-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Optimized microvascular decompression surgery for improving the results of hemifacial spasm: an analysis of reoperations.
Microvascular decompression (MVD) surgery is an effective curative treatment for hemifacial spasm (HFS). This study aims to establish techniques that may lead to favorable outcomes by analyzing reoperations in patients with persistent or recurrent HFS.Patients who exhibited persistent or recurrent HFS symptoms after prior MVD surgery were identified as candidates for reoperation. Information regarding the reoperations was collected by tracing the entire surgical procedures and peri-operative management. Clinical manifestations and follow-up data were obtained from the hospital records and subsequent visits.Twenty-six patients underwent repeat MVD surgery. Among them, multi-culprit neurovascular compression (NVC) was identified as the primary cause of failure to response to the previous operation in 73.08% of cases. Pure tissue adhesion accounted for 38.46% of cases, while shredded Teflon pledget (STP) shifting was observed in 7.69% of cases. Postoperative outcomes were assessed through revisits and categorized into four groups: excellent (76.92%), good (15.38%), fair (7.69%), and poor (0%). The longest follow-up period exceeded 65 moths.The trans-lateral suboccipital infra-floccular approach provides a better visual field. Examination of entire length of the facial nerve is essential. STP with gelatin sponge implantation is a suitable material for facilitating nerve and vascular positioning and reducing adhesion.
期刊介绍:
The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.