Abstract: Objective Introduction of neuroendoscopic-assisted techniques in the surgical treatment of microvascular decompression of primary facial muscle spasm and discussion of their efficacy.Methods Fifty patients with primary hemifacial spasm treated in our hospital from January 2019 to January 2022 were randomly divided into two groups.The control group (n=25) and the observation group (n=25) were treated with traditional microvascular decompression and the latter were treated with microvascular decompression assisted by neuroendoscope.To study the operation time,hospital stay,total effective rate of clinical treatment,muscle spasm intensity score,hemifacial spasm frequency score,facial disability index (Facial Disability Index,FDI)score,hearing level,specific quality of life (HemifacialSpasm-8,HFS-8) score,complication incidence and recurrence rate before and 6 months after treatment.Results The time of operation and hospitalization in the observation group was shorter than that in the control group,the scores of muscle spasm intensity and hemifacial spasm frequency after 6 months treatment,the incidence of complications after 7 days and 6 months follow-up,and the recurrence rate of 12 months follow-up in the observation group were lower than those in the control group,and the total effective rate,FDI score,hearing score and HFS-8 score in the observation group were higher than those in the control group.There were significant differences in the above-mentioned indexes between the two groups (P＜0.05).Conclusion The clinical effect and safety of microvascular decompression assisted by neuroendoscopy in the treatment of patients with primary hemifacial spasm are better,it is more effective to reduce the incidence of short-term and long-term complications,avoid recurrence,and improve the quality of life of patients,and wider clinical prospect.

Key words: Microvascular decompression, Primary hemifacial spasm, Efficacy, Complications, Recurrence rate

摘要： 目的 探讨神经内镜辅助显微血管减压术治疗原发性面肌痉挛的效果。方法 以随机数字表法将2019年1月至2022年1月在我院进行治疗的50例原发性面肌痉挛患者分为2组。对照组与观察组各25例,前者以传统微血管减压术治疗,后者以神经内镜辅助显微微血管减压术治疗。研究手术时间、住院时间,临床治疗总有效率,治疗前、治疗6个月后面肌痉挛强度评分、面肌痉挛频度评分、面部残疾指数量表(facial disability index,FDI)评分、听力水平、特异性生活质量(hemifacial spasm-8,HFS-8)量表评分,并发症发生率、复发率。结果 观察组手术及住院时间短于对照组,治疗6个月后面肌痉挛强度和面肌痉挛频度评分、术后7d和随访6个月并发症发生率、随访12个月复发率,观察组均低于对照组;随访6个月,观察组临床治疗总有效率、FDI评分、听力、HFS-8评分,均高于对照组;两组上述指标的差异明显(P＜0.05)。结论 将神经内镜用于显微微血管减压术,疗效和安全性更佳,临床前景更广。

关键词: 显微微血管减压术, 原发性面肌痉挛, 疗效, 并发症, 复发率