Abstract：
OBJECTIVE: This study aimed to investigate the clinical characteristics of hemifacial spasm (HFS) after Bell\'s palsy and to evaluate the therapeutic efficacy of microvascular decompression (MVD).
METHODS: A retrospective analysis was conducted on 18 patients who underwent MVD for HFS after Bell\'s palsy at our institution between January 1, 2017, and December 31, 2021. Clinical presentations, intraoperative findings, postoperative outcomes, and complications were comprehensively assessed.
RESULTS: Neurovascular compression (NVC) was identified in all the 18 patients. The offending vessels included anterior inferior cerebellar artery (AICA) in 6 patients (33.3%), posterior inferior cerebellar artery (PICA) in 7 patients (38.9%), vertebral artery (VA) combined with AICA in 3 patients (16.7%), and VA alongside PICA in 2 patients (11.1%). Notably, marked arachnoid membrane adhesion was evident in 11 patients (61.1%). 15(83.3%) patients were cured immediately after MVD, delayed relief was found in 3 (16.7%) patients. During the follow-up period, recurrence was not documented. Surgical complications were limited to facial paralysis in 3 patients and auditory impairment in 1 patient. No additional surgical complications were recorded.
CONCLUSIONS: In patients manifesting HFS after Bell\'s palsy, NVC predominantly underlies the etiology. MVD is a reliably safe and efficacious therapeutic intervention.
METHODS: A retrospective analysis was conducted on 18 patients who underwent MVD for HFS after Bell\'s palsy at our institution between January 1, 2017, and December 31, 2021. Clinical presentations, intraoperative findings, postoperative outcomes, and complications were comprehensively assessed.
RESULTS: Neurovascular compression (NVC) was identified in all the 18 patients. The offending vessels included anterior inferior cerebellar artery (AICA) in 6 patients (33.3%), posterior inferior cerebellar artery (PICA) in 7 patients (38.9%), vertebral artery (VA) combined with AICA in 3 patients (16.7%), and VA alongside PICA in 2 patients (11.1%). Notably, marked arachnoid membrane adhesion was evident in 11 patients (61.1%). 15(83.3%) patients were cured immediately after MVD, delayed relief was found in 3 (16.7%) patients. During the follow-up period, recurrence was not documented. Surgical complications were limited to facial paralysis in 3 patients and auditory impairment in 1 patient. No additional surgical complications were recorded.
CONCLUSIONS: In patients manifesting HFS after Bell\'s palsy, NVC predominantly underlies the etiology. MVD is a reliably safe and efficacious therapeutic intervention.
摘要：
目的：本研究旨在探讨贝尔面神经麻痹后面肌痉挛(HFS)的临床特点及微血管减压术(MVD)的疗效。
方法：对2017年1月1日至2021年12月31日在我院接受Bell氏麻痹后HFSMVD的18例患者进行回顾性分析。临床表现,术中发现,术后结果,并对并发症进行综合评估。
结果：在所有18例患者中均发现神经血管压迫（NVC）。6例(33.3%)患者的侵犯血管包括小脑前下动脉(AICA),小脑后下动脉(PICA)7例(38.9%),椎动脉（VA）合并AICA3例（16.7%），2例患者（11.1％）与PICA一起使用VA。值得注意的是,11例（61.1％）明显的蛛网膜膜粘连。15例（83.3%）患者MVD后立即治愈，3例(16.7%)患者出现延迟缓解。在后续期间,没有记录复发.手术并发症仅限于面瘫3例，听觉障碍1例。没有记录到额外的手术并发症。
结论：在贝尔麻痹后出现HFS的患者中，NVC主要是病因的基础。MVD是可靠的安全和有效的治疗干预。
方法：对2017年1月1日至2021年12月31日在我院接受Bell氏麻痹后HFSMVD的18例患者进行回顾性分析。临床表现,术中发现,术后结果,并对并发症进行综合评估。
结果：在所有18例患者中均发现神经血管压迫（NVC）。6例(33.3%)患者的侵犯血管包括小脑前下动脉(AICA),小脑后下动脉(PICA)7例(38.9%),椎动脉（VA）合并AICA3例（16.7%），2例患者（11.1％）与PICA一起使用VA。值得注意的是,11例（61.1％）明显的蛛网膜膜粘连。15例（83.3%）患者MVD后立即治愈，3例(16.7%)患者出现延迟缓解。在后续期间,没有记录复发.手术并发症仅限于面瘫3例，听觉障碍1例。没有记录到额外的手术并发症。
结论：在贝尔麻痹后出现HFS的患者中，NVC主要是病因的基础。MVD是可靠的安全和有效的治疗干预。
