Fully endoscopic versus microscopic vascular decompression for hemifacial spasm: a retrospective cohort study

Zhu, Jia‐Lin; Sun, Junwei; Li, Rui; Yu, Yanying; Zhang, Li

doi:10.1007/s00701-021-04824-0

Cited by 8 publications

(11 citation statements)

References 39 publications

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“…The nursing bed consists of a number of independent institutions in mechanical structure, each corresponding to more than one degree of freedom. Under the unified and coordinated control of the control system, these institutions form a multichain system, through the cooperative movement of each bed panel, so that the nursing bed completes a specific posture [ 21 ]. Therefore, the design and implementation of the control system is one of the most important parts of the whole nursing bed.…”

Section: Experiments and Analysismentioning

confidence: 99%

Nursing Education of Lateral Oblique Complications of Neurosurgery under Microscope

2022

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In order to solve the problem of nursing education of lateral oblique complications, a nursing education solution of lateral oblique complications of neurosurgery under the microscope was proposed. The method used subjective evaluation and objective evaluation to systematically evaluate the basic training module. In subjective evaluation, the authenticity score of surgical simulator was 3.65 ± 0.01 , the realism score of surgical instruments was 3.81 ± 0.01 , the realism score of tactile sense was 3.75 ± 0.01 , the operating environment score was 3.60 ± 0.01 , and the overall effect score was 3.63 ± 0.01 . The difficulty score of the whole training was 3.15 ± 0.01 . In the aspect of objective evaluation, the entropy method was used to process the data of training track, training angle, training time, trigger times, success times, failure times, and other indicators of 24 trainers collected, and the experiment verified the nursing education of lateral oblique complications of neurosurgery under the microscope.

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Section: Experiments and Analysismentioning

confidence: 99%

Nursing Education of Lateral Oblique Complications of Neurosurgery under Microscope

2022

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“…The cases demonstrated that the micro-keyhole approach was effective for patients with HFS. Contrasting the endoscopic technique with the micro-keyhole MVD, there was no difference in the size of the bone window (all within 2 cm) ( 9 , 10 ). Meantime, there was no difference in the effectiveness of MVD and the incidence of surgical complications ( 14 ).…”

Section: Discussionmentioning

confidence: 91%

“…In the first 10 years of the 20th century, with the advancement of technology, the size of the bone window gradually decreased to 3 cm (8). In the past 10 years, due to the development of endoscopic technology, the bone window of MVD was more minimally invasive, and the diameter has reduced to <2 cm (9)(10)(11). As the bone window decreases, the incidence of cerebrospinal fluid (CSF) leakage in patients is getting lower and lower.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy and Safety of <2 cm Micro-Keyhole Microvascular Decompression for Hemifacial Spasm

Huang

Zhan

et al. 2021

Front. Surg.

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Objective: Microvascular decompression (MVD) surgery has been accepted as a minimally invasive surgical modality for the treatment of hemifacial spasm (HFS). However, the size of the bone window does not match the concept of minimally invasive. This study is aimed at evaluating the efficacy and safety of <2 cm micro-keyhole MVD.Methods: A total of 148 patients with HFS diagnosed in the First Affiliated Hospital of Chongqing Medical University from January 1, 2019, to July 1, 2020, who underwent MVD in the neurosurgery department of the hospital were collected. Surgery was performed by a retrosigmoid keyhole approach with the bone hole diameter <2 cm, which was named micro-keyhole MVD. The efficacy and safety of the micro-keyhole MVD were evaluated by statistical analysis of the efficacy of the micro-keyhole MVD and the incidence of postoperative complications.Results: The effect of micro-keyhole MVD was satisfying (cure or partial remission) in 97.2% (n = 144). The failure and recurrence rates were 2.7% (n = 4) and 0.6% (n = 1), respectively. Among them, immediate facial palsy, delayed facial palsy, hearing loss, and cerebrospinal fluid (CSF) leakage were found in 0.6% (n = 1), 8.1% (n = 12), 4.7% (n = 7), and 1.3% (n = 2). Only one patient developed cerebellar infarction, which was complicated by “moyamoya disease.” The micro-keyhole MVD in the treatment of HFS can achieve a high remission rate and reduce the incidence of surgical complications.Conclusion: Micro-keyhole MVD is a safe and effective minimally invasive treatment for HFS. This technique does not increase the incidence of cranial nerve injury. Meanwhile, it reduces the incidence of CSF leakage and hearing loss (HL).

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“…The most frequent complications associated with MVD treatment for HFS encompass facial nerve paralysis and hearing loss, followed by instances of intracranial infection, wound-related issues, among others [15,16]. A previous study [13] comparing the incidence of complications post endoscopic and microscopic MVD discovered no signi cant statistical discrepancy between the two methods, but certain studies suggest [17] that neuroendoscopy may assist in minimizing hearing loss after MVD. In this study, there were two cases of postoperative complications (2/16, 12.5%).…”

Section: Discussionmentioning

confidence: 99%

Fully Endoscopic Microvascular Decompression for Hemifacial Spasm: A Clinical Study and Analysis

Zheng,

Shao,

Cai

et al. 2023

Preprint

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Objective: Fully endoscopic microvascular decompression of the facial nerve is a pivotal surgical approach for treating hemifacial spasm. However, it presents distinct surgical challenges and necessitates a learning curve. Hence, this study aimed to consolidate surgical insights and assess clinical outcomes based on a retrospective analysis of prior cases. Methods: Clinical data from 16 patients with facial nerve spasms treated at the Department of Neurosurgery in the First Affiliated Hospital of Bengbu Medical College, between August 2020 and July 2023, were retrospectively examined. Preoperatively, all patients underwent magnetic resonance angiography to confirm the presence or absence of responsible blood vessels, ascertain the relationship between responsible blood vessels, facial nerves, and brainstem, and detect any cerebellopontine angle lesions. The surgical technique encompassed entirely endoscopic microvascular decompression of the facial nerve, employing a mini sigmoid sinus posterior approach. The operative nuances and clinical efficacy were summarized and analyzed. The former encompassed intraoperative positioning, incision design, bone window parameters, mirror-handling methodology, crucial points of collaboration between the surgeon and assistant, and intraoperative management of responsible blood vessels. The latter included typical postoperative complications and the extent of relief from facial paralysis. Results: All 16 patients successfully underwent the procedure, with the responsible blood vessels identified and adequately padded during surgery. These comprised 12 cases of anterior inferior cerebellar artery (75%), 3 cases of vertebral artery (18.75%), and 1 case of posterior inferior cerebellar artery (6.25%). Intraoperative electrophysiological monitoring of lateral spread response of the facial nerve entirely vanished in 15 cases and remained unchanged in 1 case. Postoperative facial spasms were promptly alleviated in 15 cases (93.75%) and delayed in 1 case (6.25%). Two cases of postoperative complications were recorded; one instance of intracranial infection, which resolved following lumbar cistern external drainage and anti-infective treatment, and one case of tinnitus, mitigated through oral administration of mecobalamin and nimodipine. All patients were subject to follow-up, with no instances of recurrence or mortality. Conclusion: Complete endoscopic microvascular decompression of the facial nerve proves to be both safe and effective. Proficiency in endoscopy and surgical skills are pivotal, thereby discouraging novices in endoscopy from performing this procedure.

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Fully endoscopic versus microscopic vascular decompression for hemifacial spasm: a retrospective cohort study

Cited by 8 publications

References 39 publications

Nursing Education of Lateral Oblique Complications of Neurosurgery under Microscope

Nursing Education of Lateral Oblique Complications of Neurosurgery under Microscope

The Efficacy and Safety of <2 cm Micro-Keyhole Microvascular Decompression for Hemifacial Spasm

Fully Endoscopic Microvascular Decompression for Hemifacial Spasm: A Clinical Study and Analysis

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