关键词: 面肌痉挛, 椎动脉, 显微血管减压术

Abstract: Objective To investigate the significance of the classification of vertebral artery in vertebral artery related hemifacial spasm,explore the strategies of microvascular decompression,improve the therapeutic effects and reduce the complications.Methods A retrospective study was performed to analyze the clinical data of 109 cases with microvascular decompression for vertebral artery related hemifacial spasm in our hospital.In these cases,the vertebral arteries were classified into four types by its movable space.Based on the surgical practice,the influence of the classification of vertebral artery on decompression process was evaluated and the security and difficulty of operation was analyzed.The surgical strategies were summed up according to the different four types of vertebral arteries.Results The microvascular decompression surgery for hemifacial spasm with vertebral artery was a safe and effective method.In 60.55% of cases,the vertebral artery can be moved ventrally at the level of posterior cranial nerves;In 23.85% of cases,the vertebral artery can only be moved at the facial nerve level;In 0.92% of cases,there was no movable space at the level of posterior cranial nerves and the facial nerve,which made the operation difficult;In 14.68% of the cases,the bilateral vertery arteries were highly deviated to one side,which made the offending vessels complex and difficult to recognize,so the relative position of the bilateral vertebral arteries should be changed firstly,in order to win the decompression space.Conclusion The classification of the vertebral arteries is significant in microvascular decompression for vertebral artery related hemifacial spasm,which can improve the operative outcome and reduce the incidence of postoperative complications.

Key words: Hemifacial spasm, Vertery artery, Microvascular decompression