Objective To investigate the application value of multi-mode neuroelectrophysiological monitoring in microvascular decompression(MVD)for patients with hemifacial spasm(HFS).Methods The clinical data of 80 patients with HFS treated by MVD from December 2020 to March 2022 were retrospectively analyzed.Abnormal muscle response(AMR),facial motor evoked potential(FMEP)and electromyography(EMG)were used to guide the operation.Results Of these 80 patients,55 patients were cured,15 were significantly relieved,7 were partially relieved,and 3 were ineffective 1 week after operation;57 patients were cured,10 were significantly relieved,9 were partially relieved,and 4 were ineffective 6 months after operation.The effective rates were 96.3%and 95.0 at 1 week and 6 months after operation,respectively.Intraoperative AMR was disappeared in 70 patients,and present in 10.The cure rate at 1 week(74.3%)and 6 months(78.6%)after operation of patients with intraoperative AMR disappearance were significantly higher than those(30.0%and 20.0%,respectively)of patients with intraoperative AMR presence(P<0.05).FMEP was successfully evoked in all 80 patients,of whom 72 patients had no change in FMEP,6 had transient amplitude reduction and/or prolonged latency which recovered after stoping the operation,2 had amplitude reduction and no improvement after stoping the operation,and had facial paralysis after operation.EMG responses were observed in all 80 patients during the separation and exploration of the root exit zone of facial nerve,including 71 patients with transient responses and 9 with persistent facial nerve burst EMG responses which were relieved after stoping the operation.Conclusions During MVD for patients with HFS,intraoperative multimodal electrophysiological monitoring technique of AMR+FMEP+EMG plays an important role in judging the responsible vessels of HFS,improving the cure rate,protecting facial nerve function and avoiding complications.
Hemifacial spasmMicrovascular decompressionAbnormal muscle responseFacial motor evoked potentialElectromyography
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