OBJECTIVE To investigate the prognostic and predictive value of intraoperative blink reflex (BR) monitoring during microvascular decompression (MVD) for hemifacial spasm (HFS). METHODS We retrospectively reviewed 41 patients with HFS undergoing MVD with intraoperative BR and lateral spread response (LSR) monitoring. Facial spasm was evaluated for six months postoperatively. RESULTS The BR resolved in 38 patients and persisted in three after MVD. For patients who exhibited BR resolution, 1-day, 1-month, and 6-month follow-ups revealed that 35 (92.1%), 35 (92.1%), and 38 (100%) patients had spasm resolution, respectively. However, of the three patients with persistent BR, one (33.3%), one (33.3%), and zero (0%) patients exhibited spasm resolution at the three corresponding follow-ups. We found a statistically significant difference in spasm resolution between the persistent and resolved BR groups at six months postoperatively. A comparison between intraoperative BR and LSR monitoring revealed that BR was a better predictor of clinical outcomes. CONCLUSIONS Intraoperative BR monitoring is a potentially useful tool to help facilitate an adequate decompression and is a reliable prognostic predictor of surgical outcome. SIGNIFICANCE This study is the first to document the relationship between intraoperative BR monitoring and surgical outcome in patients with HFS.

中文翻译：

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术中瞬目反射监测对面肌痉挛微血管减压术手术效果的预测价值

目的探讨微血管减压术（MVD）术中眨眼反射（BR）监测对面肌痉挛（HFS）的预后和预测价值。方法 我们回顾性地审查了 41 名接受 MVD 的 HFS 患者，并进行了术中 BR 和横向扩散反应 (LSR) 监测。术后 6 个月对面部痉挛进行评估。结果 38 名患者的 BR 消退，3 名患者在 MVD 后持续存在。对于表现出 BR 消退的患者，1 天、1 个月和 6 个月的随访显示，分别有 35 (92.1%)、35 (92.1%) 和 38 (100%) 名患者出现痉挛消退。然而，在三名持续性 BR 患者中，一名 (33.3%)、一名 (33.3%) 和零 (0%) 名患者在三个相应的随访中表现出痉挛消退。我们发现术后 6 个月时持续性和已解决的 BR 组在痉挛缓解方面存在统计学显着差异。术中 BR 和 LSR 监测之间的比较显示 BR 是临床结果的更好预测指标。结论 术中 BR 监测是一种潜在有用的工具，有助于促进充分减压，并且是手术结果的可靠预后预测指标。意义 本研究首次记录了 HFS 患者术中 BR 监测与手术结果之间的关系。结论 术中 BR 监测是一种潜在有用的工具，有助于促进充分减压，并且是手术结果的可靠预后预测指标。意义 本研究首次记录了 HFS 患者术中 BR 监测与手术结果之间的关系。结论 术中 BR 监测是一种潜在有用的工具，有助于促进充分减压，并且是手术结果的可靠预后预测指标。意义 本研究首次记录了 HFS 患者术中 BR 监测与手术结果之间的关系。