Microvascular Decompressive Surgery for Hemifacial Spasm
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Hemi facial spasm (HFS), a term described in 1905 by Babinski but first reported by Schultz in 1875, is a highly morbid movement disorder characterized by intermittent involuntary movement of muscles innervated by the facial nerve.
(HFS) affects roughly 10 in 100,000 individuals in fifth or sixth decades of life.
Primary HFS is commonly attributed to vascular loops compressing the seventh cranial nerve at its exit zone from the brainstem. The facial nerve compression is thought to lead to ephaptic transmission and to hyperactivity of the facial nucleus, resulting in the involuntary facial movements.
Secondary HFS frequently follows peripheral facial palsy or may arise from facial nerve damage produced by tumours, demyelinating disorders, traumatisms, and infections accounting for 1-2 & of HFS.
Over four in five primary HFS cases involve either anterior or posterior inferior cerebellar artery as the primary offender although vertebral artery, multiple vessels and veins may be involved.
EMG recordings confirm the diagnosis by showing a typical electrophysiological signature: clonic facial muscle contractions, hyperactivity, and synkinesis, lateral spread evoked responses.
Imaging can be useful for confirming that HFS is primary in nature and due to a neurovascular compression. In most cases (95% of the patients) the compressive vessel, generally an artery, is seen on MRI combined with MR-Angiography (MRA). High resolution T2-sequence is to be used to get good delineation of the facial nerve.
Many treatments for HFS have been reported, including pharmacological agents, botulinum toxin injection, facial nerve blockage, physical therapy, radiofrequency ablation, acupuncture, as well as facial nerve combing and microvascular decompression (MVD).
However, while MVD is effective, there are still significant postoperative complications.
Tarixlər
Son Doğrulandı: | 06/30/2020 |
İlk təqdim: | 07/13/2020 |
Təxmini qeydiyyat təqdim edildi: | 07/15/2020 |
İlk Göndərmə: | 07/16/2020 |
Son Yeniləmə Göndərildi: | 07/15/2020 |
Son Yeniləmə Göndərildi: | 07/16/2020 |
Həqiqi Təhsilin Başlama Tarixi: | 08/31/2020 |
Təxmini İlkin Tamamlanma Tarixi: | 08/31/2022 |
Təxmini İşin Tamamlanma Tarixi: | 02/28/2023 |
Vəziyyət və ya xəstəlik
Müdaxilə / müalicə
Other: Microvascular Decompressive Surgery
Faza
Uyğunluq Kriteriyaları
Təhsil üçün uyğun yaşlar | 20 Years Üçün 20 Years |
Təhsilə Uyğun Cinslər | All |
Nümunə götürmə metodu | Probability Sample |
Sağlam Könüllüləri qəbul edir | Bəli |
Kriteriyalar | Inclusion Criteria: Primary Hemi facial spasm Unilateral Adults 20-60 years Clinical Diagnosis confirmed by Facial Evoked potential & Neuroimaging Exclusion Criteria: Secondary Hemi facial spasm caused by intracranial masses or other lesions Recurrent Hemi facial spasm Patients who are unfit for any neurosurgical interventions. |
Nəticə
İlkin nəticə tədbirləri
1. Samsung Medical center Grading system for Severity of Hemifacial Spasm [one month]
2. Hearing Affection [one month]
3. Recurrence [Six Month]
4. Morbidity and mortality [Six Month]
İkincili Nəticə Tədbirləri
1. changes in facial evoked EMG [one month]