Abstract:
Microvascular decompression (MVD) is a widely used surgical intervention to relieve the abnormal compression of a facial nerve caused by an artery or vein that results in hemifacial spasm (HFS). Various intraoperative neurophysiologic monitoring (ION) and mapping methodologies have been used since the 1980s, including brainstem auditory evoked potentials, lateral-spread responses, Z-L responses, facial corticobulbar motor evoked potentials, and blink reflexes. These methods have been applied to detect neuronal damage, to optimize the successful decompression of a facial nerve, to predict clinical outcomes, and to identify changes in the excitability of a facial nerve and its nucleus during MVD. This has resulted in multiple studies continuously investigating the clinical application of ION during MVD in patients with HFS. In this study we aimed to review the specific advances in methodologies and clinical research related to ION techniques used in MVD surgery for HFS over the last decade. These advances have enabled clinicians to improve the efficacy and surgical outcomes of MVD, and they provide deeper insight into the pathophysiology of the disease.
摘要:
微血管减压术(MVD)是一种广泛使用的外科手术,用于缓解由动脉或静脉引起的面神经异常压迫,从而导致面肌痉挛(HFS)。自1980年代以来,已经使用了各种术中神经生理学监测(ION)和映射方法。包括脑干听觉诱发电位,横向传播响应,Z-L响应,面部皮质球运动诱发电位,眨眼反应。这些方法已被用于检测神经元损伤,为了优化面神经的成功减压,预测临床结果,并确定MVD过程中面神经及其核兴奋性的变化。这导致多项研究持续调查ION在HFS患者MVD期间的临床应用。在这项研究中,我们旨在回顾与过去十年HFSMVD手术中使用的ION技术相关的方法和临床研究的具体进展。这些进展使临床医生能够改善MVD的疗效和手术结果,它们为疾病的病理生理学提供了更深入的见解。