KẾT QUẢ VI PHẪU THUẬT ĐIỀU TRỊ CO GIẬT NỬA MẶT TẠI BỆNH VIỆN XANH PÔN HÀ NỘI

Abstract

Objective: Hemifacial spasm (HFS) is characteterized by involuntary tonic and/or clonic contractions of facial nerve muscles. This paper aims to introduce the results of microvascular decompression for HFS in Department of Neurosurgey, Saint Paul Hospital, Hanoi. Subjects and methods: The authors conducted a single-center study of 15 patients diagnosed with HFS by clinical symptoms and brain magnetic resonance imaging. Results: 4 male patients and 11 female patients. Clinical symptoms of facial convulsions occurred on the right side in 8 cases, and seven patients had symptoms on the left side. Neurovascular compression was found in all patients, and the main culprit was the anterior inferior cerebellar artery in 7 patients, the posterior inferior cerebellar artery in 4 patients, the basilar artery in 3 patients, and the superior cerebellar artery in 1 patient. Symptoms of no facial convulsions after surgery occurred in 9 cases, and symptom reduction occurred in 6 patients. After six months of follow-up, 9 cases had no facial convulsions, 5 cases had reduced symptoms, and 01 cases had a recurrence of convulsions. Conclusion: Microsurgical neurovascular decompression is an effective technique in treating facial spasms caused by vascular conflict in the cerebellopontine angle with cranial nerve VII. To improve treatment results, surgeons need a large enough number of patients to accumulate experience, and they must consider using supporting means such as endoscopy or intraoperative neurological monitoring.