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目的探讨面神经诱发肌电图对面肌痉挛显微血管减压（ＭＶＤ）治疗的术中监测作用和术后疗效的评估。方法对２６例典型面肌痉挛患者，于ＭＶＤ术前、术中、术后，经皮刺激痉挛侧（手术侧）面神经下颌缘支，记录诱发同侧眼轮匝肌肌电位（ＭＤ－ＯＣ反应）变化，并以正常侧作对照检查。结果２６例术前均记录到痉挛侧ＭＤ－ＯＣ反应，在术中操作不同阶段，２１例见ＭＤ－ＯＣ反应消失，术后１周至３个月随访此２１例，痉挛完全消失１２例，明显减退５例，ＭＤ－ＯＣ反应不复存在，部分减轻４例再记录到ＭＤ－ＯＣ反应。另术中、术后均记录到ＭＤ－ＯＣ反应的５例，症状则无改善。结论面神经诱发肌电图用于ＭＶＤ术中监测和预后判断，有其实用价值。
Objective To investigate the intraoperative monitoring effect of facial nerve-induced EMG on microvascular decompression (MVD) in patients with hemifacial spasm and the assessment of postoperative efficacy. Methods Twenty-six patients with typical hemifacial spasm were involved in this study. The marginal mandibular branches of the facial nerve were percutaneously induced by MVD before, during and after MVD. The myoelectric potential of ipsilateral orbicularis oculi muscle (MD-OC response ) Changes, and the control side of the normal check. Results Twenty-six patients were recorded preoperative spasm side of the MD-OC reaction in different stages of operation, 21 cases of MD-OC reaction disappeared after 1 week to 3 months follow-up of 21 cases of spasm completely disappeared in 12 cases, significantly In 5 cases, the MD-OC reaction no longer existed, 4 cases were partly relieved and then recorded to MD-OC reaction. In addition, 5 cases of MD-OC reaction were recorded after operation, but the symptoms did not improve. CONCLUSIONS: Facial nerve-evoked EMG has potential value in monitoring and predicting prognosis in MVD.