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Abstract：
BACKGROUND: Microvascular decompression (MVD), the standard surgical approach for hemifacial spasm (HFS), can be divided into the interposition and transposition methods. Although the risk of HFS recurrence following interposition has been reported, there is limited data comparing long-term outcomes between both methods performed by a single surgeon. This study aimed to investigate the efficacy of MVD techniques on HFS by comparing surgical outcomes performed by a single surgeon in a single-center setting.
METHODS: A total of 109 patients who underwent MVD were analyzed and divided into the transposition (86 patients) and interposition (23 patients) groups. Postoperative outcomes at 1 month and 1 year were assessed and compared, including rates of spasm relief, complications, and recurrence.
RESULTS: Outcome assessment revealed higher rates of early spasm relief in the interposition group (66.3% vs. 100%, transposition vs. interposition, respectively, p = 0.0004), although spasm relief at 1-year postoperatively was comparable between the two groups (84.9% vs. 95.7%, transposition vs. interposition, respectively, p = 0.2929). No significant differences were observed in complication and recurrence rates. Kaplan-Meier analysis demonstrated no significant differences in the duration of spasm resolution by MVD method (p = 0.4347, log-rank test).
CONCLUSIONS: This study shows that both the transposition (Surgicel® and fibrin glue) and interposition (sponge) methods were excellent surgical techniques. The interposition method may achieve earlier spasm resolution compared to the transposition method.
METHODS: A total of 109 patients who underwent MVD were analyzed and divided into the transposition (86 patients) and interposition (23 patients) groups. Postoperative outcomes at 1 month and 1 year were assessed and compared, including rates of spasm relief, complications, and recurrence.
RESULTS: Outcome assessment revealed higher rates of early spasm relief in the interposition group (66.3% vs. 100%, transposition vs. interposition, respectively, p = 0.0004), although spasm relief at 1-year postoperatively was comparable between the two groups (84.9% vs. 95.7%, transposition vs. interposition, respectively, p = 0.2929). No significant differences were observed in complication and recurrence rates. Kaplan-Meier analysis demonstrated no significant differences in the duration of spasm resolution by MVD method (p = 0.4347, log-rank test).
CONCLUSIONS: This study shows that both the transposition (Surgicel® and fibrin glue) and interposition (sponge) methods were excellent surgical techniques. The interposition method may achieve earlier spasm resolution compared to the transposition method.
摘要：
背景：微血管减压术（MVD），面肌痉挛（HFS）的标准手术方法，可分为间置法和转置法。尽管已经报道了介入后HFS复发的风险，由一名外科医生进行的两种方法的长期结局比较数据有限.本研究旨在通过比较单个外科医生在单中心环境中进行的手术结果来研究MVD技术对HFS的疗效。
方法：对109例MVD患者进行分析，分为转位组（86例）和间位组（23例）。评估并比较术后1个月和1年的结果，包括痉挛缓解率，并发症,和复发。
结果：结果评估显示，干预组早期痉挛缓解率较高（66.3%vs.100%,转座vs.插入，分别,p=0.0004),尽管术后1年痉挛缓解在两组之间具有可比性(84.9%vs.95.7%,转座vs.插入，分别,p=0.2929）。并发症和复发率无明显差异。Kaplan-Meier分析表明，MVD方法在痉挛消退的持续时间上没有显着差异（p=0.4347，对数秩检验）。
结论：这项研究表明，移位（Surgicel®和纤维蛋白胶）和插入（海绵）方法都是出色的手术技术。与转座方法相比，插入方法可以实现更早的痉挛解决。
方法：对109例MVD患者进行分析，分为转位组（86例）和间位组（23例）。评估并比较术后1个月和1年的结果，包括痉挛缓解率，并发症,和复发。
结果：结果评估显示，干预组早期痉挛缓解率较高（66.3%vs.100%,转座vs.插入，分别,p=0.0004),尽管术后1年痉挛缓解在两组之间具有可比性(84.9%vs.95.7%,转座vs.插入，分别,p=0.2929）。并发症和复发率无明显差异。Kaplan-Meier分析表明，MVD方法在痉挛消退的持续时间上没有显着差异（p=0.4347，对数秩检验）。
结论：这项研究表明，移位（Surgicel®和纤维蛋白胶）和插入（海绵）方法都是出色的手术技术。与转座方法相比，插入方法可以实现更早的痉挛解决。
