Microvascular Decompressive Surgery for Hemifacial Spasm: Nuances of Technique and Outcome
试验速览
- 阶段
- 不适用
- 入组人数
- 30
- 主要终点
- Morbidity and mortality
研究概览
简要总结
- Review the clinical outcomes of Micro vascular decompression of Hemi facial Spasm.
- Assess safety and efficacy of Micro vascular decompression.
- Improve the outcome of these patients and decease rate of recurrence and complications.
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Prospective
入排标准
- 年龄范围
- 20 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Primary Hemi facial spasm Unilateral Adults 20-60 years Clinical Diagnosis confirmed by Facial Evoked potential & Neuroimaging
排除标准
- •Secondary Hemi facial spasm caused by intracranial masses or other lesions Recurrent Hemi facial spasm Patients who are unfit for any neurosurgical interventions.
结局指标
主要结局
Morbidity and mortality
时间窗: Six Month
Morbidity and mortality rates related to the procedure using modified Rankin Scale
Hearing Affection
时间窗: one month
Audiometry: to detect the degree of post-operative hearing affection using WHO Grading system For Hearing Loss
Samsung Medical center Grading system for Severity of Hemifacial Spasm
时间窗: one month
Success rate by assessing the degree of hemifacial spasm pre and post-operative using the SMC grading system proposed by Lee et all
Recurrence
时间窗: Six Month
Recurrence rate within the duration of follow up
次要结局
- changes in facial evoked EMG(one month)
研究者
Ahmed Zanaty
Asisstant Lecturer
Assiut University