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目的探讨特发性面肌痉挛(HFS)显微血管减压术中对椎动脉压迫的处理。方法回顾性分析采用显微血管减压术治疗的106例面肌痉挛病例,35例(33.0%)术中探查发现面、听神经出(进)脑干区(REN)有椎动脉通过。椎动脉处理方法:用Teflon棉包绕椎动脉后推向颅壁或天幕硬膜,将局部硬膜电凝使之变粗糙,在责任动脉或包绕动脉的Teflon棉与该处硬膜之间涂以少量医用耳脑胶固定,将椎动脉悬吊离开REN。结果35例患者术后即刻有效率100%,治愈34例(97.1%),另1例即刻未治愈而于术后3周延迟治愈。平均随访12个月,无复发病例。与椎动脉处理有关的术后并发症:听力下降伴耳鸣2例,随访期间均好转。结论处理方法该椎动脉达到满意减压效果。术后面、听神经并发症的发生率无增加。
Objective To investigate the treatment of vertebral artery compression during idiopathic hemifacial spasm (HFS) microvascular decompression. Methods A total of 106 cases of hemifacial spasm treated by microvascular decompression were retrospectively studied. 35 cases (33.0%) were found by intraoperative exploration and the vertebral artery was passed through the brainstem area (REN). Vertebral Artery Treatment: Teflon cotton wrapped around the vertebral artery into the skull wall or cephalad, the local dural coagulation to make it rough in the responsible artery or the artery surrounded by Teflon cotton and the dura between Coated with a small amount of medical ear glue, the vertebral artery suspended from the REN. Results 35 patients were immediately after the operation of 100% efficiency, cured 34 cases (97.1%), the other 1 case immediately cured 3 weeks postoperatively. The average follow-up of 12 months, no recurrence. Postoperative complications related to vertebral artery treatment: 2 cases of hearing loss accompanied with tinnitus, all improved during follow-up. Conclusion The treatment of vertebral artery to achieve satisfactory decompression effect. After surgery, there was no increase in the incidence of auditory neurological complications.