目的:探讨术前腰大池引流在面肌痉挛微血管减压中的应用指征及体会。方法对5例面肌痉挛术前MRI显示后颅窝形态及蛛网膜下腔狭小的患者,术前行腰大池引流,观察微血管减压术疗效及术后并发症,并对其进行总结。结果5例患者在术前行腰大池引流后,常规行微血管减压手术,术中空间显露良好,脑组织牵拉程度较小,术后患者恢复良好,痉挛消失,且无面瘫、听力改变、声音嘶哑及小脑损伤表现。结论术前行腰大池置管引流可降低颅内压,术中手术视野显露增大,减少对脑组织的牵拉,利于手术操作、可减少并发症,提高疗效。
Objective To evaluate the indications of preoperative lumbar cistern drainage during microvascular decompression ( MVD) for hemifacial spasm( HFS) .Methods 5 patients with hemifacial spasm who with narrow posterior fossa and subarachnoid displayed by preoperative magnetic resonance imaging were used preoperative lumbar cisten drainage.The surgical outcomes and postoperative complications were analyzed retrospectively.Results 5 patients with preoperative lumbar drainage, obtained better exposure and less brain tissue retractin during microvascular decompression.All patients had complete relief of the symptoms without facial paralysis, hearing loss,hoarseness and cerebellum damage.Conclusion Preoperative lumbar cistern drainage can reduce the intracranial pressure, increase the intraoperative exposure, decrease the postoperative complications and improve outcome.