Spasm Freedom Following Microvascular Decompression for Hemifacial Spasm: Systematic Review and Meta-Analysis.
Spasm Freedom Following Microvascular Decompression for Hemifacial Spasm: Systematic Review and Meta-Analysis.
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DOI：
10.1016/j.wneu.2020.04.001
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发表时间：
2020-07
影响因子：
2
通讯作者：
Rolston JD
中科院分区：
文献类型：
--
作者：
Holste K;Sahyouni R;Teton Z;Chan AY;Englot DJ;Rolston JD
面肌痉挛（HFS）是一种以面神经支配的肌肉间歇性不自主运动为特征的衰弱性疾病。HFS是由沿着面神经根出口区的神经血管压迫引起的，可以通过微血管减压术（MVD）治疗。目的是确定MVD治疗HFS后痉挛消除率和预测因素。使用关键词“微血管减压术”和“面肌痉挛”进行文献检索。主要结局变量是末次随访时的痉挛自由度。完成分析以评价与无痉挛结局相关的变量。共分析了39项研究，包括6249例患者。随访1.25 ± 0.04年时，总体无痉挛率为90.5%（5652/6249）。无痉挛与持续性痉挛与手术时年龄、随访时间、性别、病程、疾病部位或血管类型之间无显著关系。初次手术后痉挛消失的可能性高于再次MVD（比值比4.16，95%置信区间1.99-8.68; P < 0.01）。MVD治疗HFS效果良好，在39项研究的6249例患者中，1年随访时治愈率>90%。与重复MVD相比，1年时长期无痉挛的显著预测因素是初始MVD。大多数关于HFS MVD的已发表手稿是异质性单机构回顾性研究。因此，在缺乏随机对照研究的情况下，报告结局率和评价痉挛自由的重要预测因素的大规模荟萃分析具有实用性。
Hemifacial spasm (HFS) is a debilitating disorder characterized by intermittent involuntary movement of muscles innervated by the facial nerve. HFS is caused by neurovascular compression along the facial nerve root exit zone and can be treated by microvascular decompression (MVD). The goal was to determine rates and predictors of spasm freedom after MVD for HFS. A literature search using the key terms “microvascular decompression” and “hemifacial spasm” was performed. The primary outcome variable was spasm freedom at last follow-up. Analysis was completed to evaluate for variables associated with spasm-free outcome. A total of 39 studies including 6249 patients were analyzed. Overall spasm freedom rate was 90.5% (5652/6249) at a follow-up of 1.25 ± 0.04 years. There was no significant relationship between spasm freedom versus persistent spasm and age at surgery, timing of follow-up, gender, disease duration, side of disease, or vessel type. Spasm freedom was more likely after an initial surgery versus a redo MVD (odds ratio 4.16, 95% confidence interval 1.99–8.68; P < 0.01). MVD works well for HFS with cure rates >90% at 1-year follow-up in 6249 patients from 39 studies. A significant predictor of long-term spasm freedom at 1 year was an initial MVD as compared to repeat MVD. The majority of published manuscripts on MVD for HFS are heterogeneous single-institutional retrospective studies. As such, a large-scale meta-analysis reporting outcome rates and evaluating significant predictors of spasm freedom provides utility in the absence of randomized controlled studies.
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影响因子：
2.4
作者：
Chang, Won Seok;Chung, Jong Chul;Chang, Jin Woo
通讯作者：
Chang, Jin Woo
DOI：
10.17116/neiro201680144-56
发表时间：
2016-01-01
期刊：
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko
影响因子：
--
作者：
Grigoryan, Yu A;Sitnikov, A R;Grigoryan, G Yu
通讯作者：
Grigoryan, G Yu
影响因子：
4.8
作者：
HANAKITA, J;KONDO, A
通讯作者：
KONDO, A
影响因子：
--
作者：
Defazio, G;Abbruzzese, G;Berardelli, A
通讯作者：
Berardelli, A
影响因子：
1.1
作者：
Hatem, J;Sindou, M;Vial, C
通讯作者：
Vial, C