面肌痉挛患者显微血管减压术中侧方扩散反应与术后近远期疗效的关系OA

Objective To investigate the relationship between lateral spread response(LSR)during microvascular decompression(MVD)and short-and long-term postoperative curative effects in patients with hemifacial spasm.Methods The clinical data of 110 patients with hemifacial spasm admitted to Xuzhou Central Hospital from February 2020 to February 2024 were retrospectively analyzed.Patients with disappearance of zygomatic branch and marginal mandibular branch LSR or the disappearance of any one of the two branches were classified as LSR disappearance group(n=97),and patients without disappearance of zygomatic branch and marginal mandibular branch LSR were set as LSR non-disappearance group(n=13).The disappearance status of LSR in zygomatic branch and marginal mandibular branch in the LSR disappearance group was analyzed.The relationship between presence or absence of LSR disappearance and disappearance timing and short-term(within 1 week)and long-term(1 week to 1 year)postoperative curative effects was analyzed.Receiver operating characteristic(ROC)curve was drawn to evaluate presence or absence of LSR disappearance and disappearance timing on predicting the short-and long-term curative effects of hemifacial spasm after surgery.Results The short-and long-term postoperative curative effects in the LSR disappearance group were better than those in the LSR non-disappearance group(P＜0.05).There were statistical differences of short-and long-term curative effects of postoperative hemifacial spasm in different intraoperative LSR disappearance timing patients(P＜0.05).ROC curve analysis showed that the AUCs of presence or absence of LSR disappearance in evaluating the short-and long-term curative effects of hemifacial spasm after surgery were respective 0.621 and 0.702,and the sensitivity was respective 90.82％and 90.38％,and the specificity was respective 33.33％and 50.00％.The AUCs of LSR disappearance timing were respective 0.631 and 0.691,and the sensitivity was 63.73％and 63.21％,and the specificity was 62.50％and 75.00％.Conclusion Presence or absence of LSR disappearance and disappearance timing have certain predictive value in the short-and long-term curative effects after MVD in patients with hemifacial spasm.Clinicians should make a comprehensive judgment in combination with clinical symptoms and other auxiliary examinations in order to improve the long-term prognosis.