Preoperative Three-Dimensional Reconstruction and Neuroendoscopy in Microvascular Decom-pression of the Posterior Sigmoid Nerve:Risk Factor Analysis for Postoperative Complications
Objective To evaluate the application value of preoperative three-dimensional reconstruction combined with neuroendoscopic assistance in microvascular decompression of pos-terior sigmoid sinus nerves and analyze the risk factors for postoperative complications.Methods A retrospective analysis was conducted on 244 patients with hemifacial spasm admitted to our hospital from January 2021 to December 2023.They were divided into a control group(126 cases)who received conventional microvascular decompression(MVD)and a control group who received three-dimensional reconstruction combined with nerve surgery.Observation group of endoscopi-cally assisted MVD(118 cases).Study indicators included perioperative data,Cohen spasticity score,inflammatory markers(IL-6,TNF-α),quality of life scores,clinical efficacy and compli-cations.Univariable and multivariable logistic regression analysis were used to explore the related risk factors for postoperative complications.Results The operation time,intraoperative blood loss and hospitalization time of the patients in the observation group were significantly shorter than those in the control group.The 6-month follow-up after surgery showed that the observation group was better than the control group in terms of improvement in Cohen's spasticity score,re-duction in IL-6 and TNF-α inflammation levels,and improvement in quality of life score(P＜0.05).In terms of efficacy,the overall effective rate of the observation group was 94.92％,which was significantly higher than the 82.54％of the control group(Z=4.461,P=0.000;x2=9.187,P=0.002).The incidence rate of complications in the observation group was 8.47％,which was significantly lower than the 17.46％in the control group(x2=4.318,P=0.038).Logistic regres-sion analysis showed that treatment method(OR=0.605,95％CI:0.4980.734)was a negative predictor of complications,while arteriosclerosis(OR=2.158,95％CI:1.7602.645)and hyper-tension status were responsible.(OR=1.449,95％CI:1.222～1.719)is a positive predictor.Con-clusion Three-dimensional reconstruction combined with neuroendoscopic-assisted microvas-cular decompression can effectively optimize the perioperative indicators of patients with hemifa-cial spasm,significantly improve clinical symptoms,reduce inflammatory reactions,improve quali-ty of life,and is highly safe.Hypertension,responsible arteriosclerosis and surgical method are in-dependent predictors of postoperative complications.
NETL
NSTL
万方数据
