Electromyographically Guided Nerve Combing Makes Microvascular Decompression More Successful in Hemifacial Spasm with Persistent Abnormal Muscle Response.

Related Articles

Electromyographically Guided Nerve Combing Makes Microvascular Decompression More Successful in Hemifacial Spasm with Persistent Abnormal Muscle Response.

World Neurosurg. 2017 Feb 27;:

Authors: Zhang X, Zhu J, Tang YD, Zhao H, Ying TT, Yuan Y, Li ST

Abstract
BACKGROUND: Microvascular decompression (MVD) of the facial nerve monitored intra-operatively by abnormal muscle response (AMR) activity is a common treatment for hemifacial spasm. However, AMR frequently persists after MVD, for which electromyographically (EMG)-guided nerve combing is sometimes recommended. Because no research regarding the success of EMG-guided nerve combing has been published, we compared the effectiveness of nerve combing after MVD with simple MVD in cases including persistent AMR.
METHODS: A retrospective study of 127 cases of HFS treated with persistent AMR after MVD treatment occurring between January 2011 and June 2015 was conducted. Among the 127 total cases, EMG-guided nerve combing was used in 72 patients, and simple MVD in 55 patients.
RESULTS: For simple MVD, success rates at 1 day, 7 days, 1 month, 3 months, and 1 year after surgery were all approximately 80%; the success rates of MVD with nerve combing were significantly (P<0.05) higher than those of simple MVD, by 15.83%, 15.4%, 17.22%, 17.65%, and 17.65%, respectively. The incidence rates of facial palsy in simple MVD were 12.73%, 14.55%, 10.91%, 3.64%, and 1.82%, respectively; those in the nerve combing group were 27.78% (P<0.05 vs. simple MVD), 33.33% (P<0.05), 25.00% (P=0.05), 5.55% (P>0.05), and 2.78% (P>0.05), respectively.
CONCLUSIONS: In cases of hemifacial spasm with persistent AMR after MVD, EMG-guided nerve combing significantly improved the success rate of the operation. Although it also significantly increased the incidence of post-operative facial palsy over the short-term (up to 1 week), incidences in the long-term were not significantly different.

PMID: 28254601 [PubMed - as supplied by publisher]

http://ift.tt/2m71Od0