摘要
目的 探讨青年面肌痉挛（HFS）患者的临床特征、发病原因及显微血管减压术的治疗效果.方法 2010年1月至2013年12月南京大学医学院附属鼓楼医院神经外科采用显微血管减压术治疗HFS患者982例,回顾性分析其中17例（1.7％）发病年龄≤22岁患者的临床特征及治疗效果.结果 17例患者均为单侧HFS;其中男4例,女13例;发病年龄14 ～ 22岁,平均为（19.4±2.3）岁;病程l～11年,平均为（5.5±3.0）年.术前MRI显示,17例责任血管平均外径为（1.66 ±0.81）mm,后颅窝平均夹角为（29.92±4.78）..术中均可见责任动脉压迫面神经根出脑干区,14例可见不同程度的局部解剖变异、责任动脉异常.16例获得临床治愈,其中14例术后即刻治愈,延迟治愈2例（术后1、3个月）,随访至今（1 ～3年）未复发;术后10 d复发1例;迟发性面瘫（术后第14天）及声音嘶哑各1例,治疗后均好转.结论 在HFS患者中,青年患者所占的比率较低.局部解剖变异,责任动脉异常导致动脉压迫面神经根部是其主要的发病原因.显微血管减压术对其有较好的疗效.
Objective To investigate the clinical characteristics,causes and surgical treatment of young onset hemifacial spasm patients.Methods A total of 982 patients underwent microvascular decompression （MVD） for hemifacial spasm （HFS） in Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School from January,2010 to December,2013.17 patients with the onset age ≤22 years old were analyzed retrospectively.Results Among the 17 unilateral HFS patients,4 were males and 13 were females.The mean age of onset was [19.4 ±2.3（14-22）] years.The mean duration before operation was [5.5 ± 3.0 （1-11）] years.The preoperative MRI showed that the average outside diameter of the offending vessels was （1.66 ± 0.81） mm,the average angle of the posterior fossa was （29.92 ± 4.78） ＆#176;.The offending arteries were observed in all patients.The local anatomic variations and exceptional arteries were found in 14 patients.16 patients got a clinical resolution,of which 14 cases were cured immediately,delayed resolution （1,3 months after surgery） was found in two cases,without recurrence during the follow-up period（1-3 years）.One patient relapsed 10 d after the surgery.One case of delayed facial paralysis （14 days after surgery） and one hoarseness were observed.Conclusions Young onset HFS patients were rare.Exceptional arteries and anatomic structural variation might be the main causes of this disease.MVD had good effect.
出处
《中华神经外科杂志》
CSCD
北大核心
2015年第3期259-263,共5页
Chinese Journal of Neurosurgery
关键词
微血管减压术
青少年
疾病特征
面肌痉挛
Microvascular decompression surgery
Adolescent
Disease attributes
Hemifacial spasm
