Download PDF
J Neurol Surg A Cent Eur Neurosurg 2020; 81(03): 195-199
DOI: 10.1055/s-0039-1698461
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Clinical Research on Delayed Cure after Microvascular Decompression for Hemifacial Spasm

Ming-Wu Li 
1   Department of Neurosurgery, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Anhui Provincial Stereotactic Neurological Institute, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei, Anhui, China
,
Xiao-Feng Jiang
1   Department of Neurosurgery, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Anhui Provincial Stereotactic Neurological Institute, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei, Anhui, China
,
Min Wu 
2   Medical School, Shandong University, Jinan, China
3   Anhui Provincial Hospital, Hefei, China
,
Fang He
4   Department of Electrophysiology, First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, China
,
Chaoshi Niu
1   Department of Neurosurgery, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Anhui Provincial Stereotactic Neurological Institute, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei, Anhui, China
› Author Affiliations
Further Information

Publication History

16 April 2019

06 August 2019

Publication Date:
10 October 2019 (online)

Also available at
    Permissions and Reprints

Abstract

Objective The clinical data of patients with hemifacial spasm (HFS) were analyzed statistically to identify factors leading to delayed cure after microvascular decompression (MVD).

Methods A retrospective analysis of the clinical data of 600 patients with HFS subjected to MVD from March 2016 to May 2018 was performed. Student t test, chi-square test, logistic regression analysis, and multivariate analysis of variance were used to analyze the correlation between delayed cure and its related factors.

Results Among the 600 patients enrolled, 117 had delayed cure after MVD. The shortest duration of delayed cure was 4 days, and the longest was 540 days, with an average of 108 days. The frequency of delayed improvement in these patients was not associated with sex, age, or offending vessel type (p > 0.05); however, delayed cure was positively correlated with the course of the disease, grade of HFS severity, and disappearance of abnormal muscle responses during the operation (p < 0.05). Moreover, a longer disease course was associated with more severe related symptoms and a longer duration of postoperative delayed cure.

Conclusion MVD is an effective treatment for HFS. Given that postoperative delayed cure was unavoidable, even with accurate identification of the offending vessel and sufficient decompression of the root exit zone, delayed cure should be considered in patients undergoing reoperation due to lack of remission or relapse after the operation. Additionally, the timing of efficacy assessments should be delayed.

Keywords

hemifacial spasm - microvascular decompression - delayed cure
 

  • References

  • 1 Sajadi MM, Sajadi MR, Tabatabaie SM. The history of facial palsy and spasm: Hippocrates to Razi. Neurology 2011; 77 (02) 174-178
    CrossrefPubMedSearch in Google Scholar
  • 2 Ishikawa M, Nakanishi T, Takamiya Y, Namiki J. Delayed resolution of residual hemifacial spasm after microvascular decompression operations. Neurosurgery 2001; 49 (04) 847-854 ; discussion 854–856
    PubMedSearch in Google Scholar
  • 3 Oh ET, Kim E, Hyun DK, Yoon SH, Park H, Park HC. Time course of symptom disappearance after microvascular decompression for hemifacial spasm. J Korean Neurosurg Soc 2008; 44 (04) 245-248
    CrossrefPubMedSearch in Google Scholar
  • 4 Huh R, Han IB, Moon JY, Chang JW, Chung SS. Microvascular decompression for hemifacial spasm: analyses of operative complications in 1582 consecutive patients. Surg Neurol 2008; 69 (02) 153-157 ; discussion 157
    CrossrefPubMedSearch in Google Scholar
  • 5 Guclu B, Sindou M, Meyronet D, Streichenberger N, Simon E, Mertens P. Cranial nerve vascular compression syndromes of the trigeminal, facial and vago-glossopharyngeal nerves: comparative anatomical study of the central myelin portion and transitional zone; correlations with incidences of corresponding hyperactive dysfunctional syndromes. Acta Neurochir (Wien) 2011; 153 (12) 2365-2375
    CrossrefPubMedSearch in Google Scholar
  • 6 Sindou M, Keravel Y. Neurosurgical treatment of primary hemifacial spasm with microvascular decompression [in French]. Neurochirurgie 2009; 55 (02) 236-247
    CrossrefPubMedSearch in Google Scholar
  • 7 Goto Y, Matsushima T, Natori Y, Inamura T, Tobimatsu S. Delayed effects of the microvascular decompression on hemifacial spasm: a retrospective study of 131 consecutive operated cases. Neurol Res 2002; 24 (03) 296-300
    CrossrefPubMedSearch in Google Scholar
  • 8 Ghai A, Garg N, Hooda S, Gupta T. Spasticity—pathogenesis, prevention and treatment strategies. Saudi J Anaesth 2013; 7 (04) 453-460
    CrossrefPubMedSearch in Google Scholar
  • 9 Ray DK, Bahgat D, McCartney S, Burchiel KJ. Surgical outcome and improvement in quality of life after microvascular decompression for hemifacial spasms: a case series assessment using a validated disease-specific scale. Stereotact Funct Neurosurg 2010; 88 (06) 383-389
    CrossrefPubMedSearch in Google Scholar
  • 10 Zhang P, Selim MH, Wang H. , et al. Intraoperative measuring of the offending vessel's pressure on the facial nerve at root exit zone in patients with hemifacial spasm during microvascular decompression: a prospective study. World Neurosurg 2019; 122: e89-e95
    CrossrefPubMedSearch in Google Scholar
  • 11 Sindou M, Mercier P. Microvascular decompression for hemifacial spasm: outcome on spasm and complications. A review. Neurochirurgie 2018; 64 (02) 106-116
    CrossrefPubMedSearch in Google Scholar
  • 12 Joo WI, Lee KJ, Park HK, Chough CK, Rha HK. Prognostic value of intra-operative lateral spread response monitoring during microvascular decompression in patients with hemifacial spasm. J Clin Neurosci 2008; 15 (12) 1335-1339
    CrossrefPubMedSearch in Google Scholar
  • 13 Thirumala PD, Shah AC, Nikonow TN. , et al. Microvascular decompression for hemifacial spasm: evaluating outcome prognosticators including the value of intraoperative lateral spread response monitoring and clinical characteristics in 293 patients. J Clin Neurophysiol 2011; 28 (01) 56-66
    CrossrefPubMedSearch in Google Scholar
  • 14 Lee JM, Park HR, Choi YD. , et al. Delayed facial palsy after microvascular decompression for hemifacial spasm: friend or foe?. J Neurosurg 2018; 129 (02) 299-307
    PubMedSearch in Google Scholar