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題 名 | Microvascular Decompression for Hemifacial Spasm Indication of Reoperation and Results in 290 Patients=顯微血管減壓手術治療半面痙攣290病例報告及二度手術的探討 |
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作 者 | 黃俊一; 陳一信; 李良雄; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 24:2 民80.03-04 |
頁 次 | 頁600-605 |
分類號 | 416.293 |
關鍵詞 | 顯微血管減壓手術; 半面痙攣; 二度手術; |
語 文 | 英文(English) |
中文摘要 | 自1983至1989年,台北榮民總醫院神經外科曾為290例半面痙攣的患者施行乳突後枕骨下開顱術及顯微血管減壓術。經過長達9個月至7年(平均3.5年)的術後追蹤,其中270例(93.1%)經由一次手術即完全解除症狀,16例(5.5%)經一次手術後症狀持續但再度接受手術後症狀消失,其餘4例手術後亦有明顯改善,我們發現在64%的患者半面痙攣是由前下小腦動脈(AICA)有關的血管壓迫顏面神經根出口區(REZ)所造成。總共的治癒率高達98.6 %,手術的併發症不多,沒有手術死亡率及術後復發。 在手術後痙攣仍持續3天以上的患者,我們追蹤發現80%(16/20)有延遲自發性的痊癒,而75%的延遲自發性痊癒發生於術後6個月之內。 經由以上觀察,我們建議若半面痙攣患者接受顯微血管滅壓手術後仍有持續性痙攣,最好觀察至少6個月之後再考慮是否需接受二度手術。 |
英文摘要 | From 1983 to 1989, retromastoid suboccipital craniectomy with microvascular decompression (MVD) was performed on 290 patients with hemifacial spasm (HFS) at Veterans General Hospilal-Taipei. The duration ofpostoperative follow-up ranged from 9 months to 7 years, with the mean duration of 3.5 years. The spasm ceased after one MVD in 270 cases (93.1%), the spasm persisted but ceased after a second MVD in 16 cases (5.5%), with the overall cure rate 98.6% in this series, the rest 4 cases also showed a significant improvement after the operation. Anterior inferior cerebellar artery (AICA) was found to be related to the vascular cross compression on the root exit zone (REZ) of the facial nerve in 64% of our patients. Complications were mostly few and minor, only 2.7% of patients with permanent deficits. Neither operative mortality nor symptom recurrence had been noted. Delayed spontaneous cure was found in 80% (16/20) of our patients whose spasm persisted longer than 3 days after MVD, and 75% of delayed spontaneous cure occurred within 6 months. Therefore, we suggested the reoperation for patients whose spasms persisted after MVD should be postponed after a period of observation for at least 6 months. |
本系統中英文摘要資訊取自各篇刊載內容。