微骨窗与标准骨窗入路对面肌痉挛术后头痛影响的研究进展

A Review on the Impact of Micro-Bone Window Versus Standard Bone Window Approach on Postoperative Headache in Hemifacial Spasm Surgery

摘要: 面肌痉挛作为一种常见的神经肌肉疾病，其手术治疗效果与术后并发症管理始终是临床关注的重点。骨窗入路是面肌痉挛微血管减压手术中的关键环节，其选择直接影响患者术后恢复质量，尤其是头痛的发生情况。目前，关于微骨窗与标准骨窗入路对术后头痛影响的研究仍存在分歧与争议，尚缺乏系统性的梳理与总结。本文通过系统回顾与综合分析相关文献，对两种入路方式在术后头痛发生率方面的差异进行探讨，并结合其解剖学基础与手术技术特点，评述其对术后头痛发生机制的可能影响。本研究旨在为临床实践中选择更优骨窗入路提供参考依据，以期降低术后头痛发生率，改善患者生活质量，并促进神经外科手术技术的进一步完善。

Abstract: Hemifacial spasm, a common neuromuscular disorder, continues to place surgical outcomes and postoperative complication management at the forefront of clinical concern. In microvascular decompression surgery for this condition, the choice of bone window approach critically affects the quality of recovery, particularly with regard to postoperative headache incidence. Existing studies comparing micro-bone window and standard bone window approaches reveal inconsistent findings and ongoing debate, underscoring the need for a comprehensive synthesis of available evidence. This review systematically examines the relevant literature to compare postoperative headache rates between the two surgical approaches. By considering their anatomical and technical distinctions, it further explores how these factors may contribute to headache mechanisms. The findings are intended to support evidence-based clinical decision-making in selecting a bone window approach, with the goal of reducing postoperative headache frequency, improving patients’ quality of life, and contributing to the refinement of neurosurgical technique.