Delayed Cranial Nerve Palsy after Microvascular Decompression for Hemifacial Spasm

Han, Jae-Suk; Lee, Jeong-Ah; Kong, Doo‐Sik; Park, Kwan

doi:10.3340/jkns.2012.52.4.288

Cited by 24 publications

(24 citation statements)

References 17 publications

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“…[1,10,11] The incidence of DFP after MVD for HS ranges from 2.8% to 8.3% as quoted in various reports. [3,5,6,12,13] Rhee et al noted an incidence of 5.4% (21 cases) in their series of 410 cases of MVD performed for HS. [6] In another retrospective analysis of 248 cases of MVD for HS, the authors noted an incidence of 6.5% (16 cases).…”

Section: Discussionmentioning

confidence: 98%

“…[3,4,6,13,14] The etiology of DFP remains unclear and DFP can develop even after a successful operation up to several days after MVD. [3,5] Hence, it is believed that direct trauma to the nerve is an unlikely cause of this complication. [4] Kim et al opined that the possible causes include facial nerve exit zone injury through the Teflon felt or delayed facial nerve edema.…”

Section: Discussionmentioning

confidence: 99%

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Delayed Facial Palsy after Microvascular Decompression: Report of Two Cases

Prasad

Kumar

Menon

2017

Journal of Neurosciences in Rural Practice

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Microvascular decompression (MVD) is a novel surgical procedure predominantly performed for treating trigeminal neuralgia (TN) and hemifacial spasm (HS). Multiple studies have proven the long-term success of MVD for both these conditions. The most common complications of MVD reported include chemical meningitis, facial hypesthesia, cerebrospinal fluid leak, facial paresis, and hearing loss. Delayed facial palsy (DFP) is an uncommon complication mostly noted in MVD for HS and after the removal of acoustic tumors. We report two cases of DFP occurring after performing MVD, one each for HS and TN. This is also the first case of DFP to be reported after MVD for TN. Both were young females who developed DFP 2 weeks after surgery. They were managed with oral steroids and acyclovir for 2–3 weeks and achieved excellent outcome at an average of 4.5 weeks from the onset. We conclude that although majority of the cases improve spontaneously, steroids and acyclovir might assist in faster recovery.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Delayed Facial Palsy after Microvascular Decompression: Report of Two Cases

Prasad

Kumar

Menon

2017

Journal of Neurosciences in Rural Practice

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“…Investigate its reason may be that12,17): first, some electric coagulation thermal injury of facial nerve could make its anatomy seem normally in the operation, but its function may have been damaged; second, some blood vessels for nutrition nerve may not be protected well during operation, which may cause postoperative nerve injury of ischemia and hypoxia. We know that cerebral vascular distribution is important to the nerver funtion8,15). Therefore, when the tumor resection underwent retrosigmoid approach, we should pay attention to the following problems: 1) in the process of separating the tumor and pons, we must be always along the two tissue interface, first to separate arachnoid of tumor surface while must protect peripheral nerve and blood vessel.…”

Section: Discussionmentioning

confidence: 99%

Influencing Factors Analysis of Facial Nerve Function after the Microsurgical Resection of Acoustic Neuroma

Hong

Cheng

Wang

et al. 2017

J Korean Neurosurg Soc

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ObjectiveTo explore and analyze the influencing factors of facial nerve function retainment after microsurgery resection of acoustic neurinoma.MethodsRetrospective analysis of our hospital 105 acoustic neuroma cases from October, 2006 to January 2012, in the group all patients were treated with suboccipital sigmoid sinus approach to acoustic neuroma microsurgery resection. We adopted researching individual patient data, outpatient review and telephone followed up and the House-Brackmann grading system to evaluate and analyze the facial nerve function.ResultsAmong 105 patients in this study group, complete surgical resection rate was 80.9% (85/105), subtotal resection rate was 14.3% (15/105), and partial resection rate 4.8% (5/105). The rate of facial nerve retainment on neuroanatomy was 95.3% (100/105) and the mortality rate was 2.1% (2/105). Facial nerve function when the patient is discharged from the hospital, also known as immediate facial nerve function which was graded in House-Brackmann: excellent facial nerve function (House-Brackmann I–II level) cases accounted for 75.2% (79/105), facial nerve function III–IV level cases accounted for 22.9% (24/105), and V–VI cases accounted for 1.9% (2/105). Patients were followed up for more than one year, with excellent facial nerve function retention rate (H-B I–II level) was 74.4% (58/78).ConclusionAcoustic neuroma patients after surgery, the long-term (≥1 year) facial nerve function excellent retaining rate was closely related with surgical proficiency, post-operative immediate facial nerve function, diameter of tumor and whether to use electrophysiological monitoring techniques; while there was no significant correlation with the patient’s age, surgical approach, whether to stripping the internal auditory canal, whether there was cystic degeneration, tumor recurrence, whether to merge with obstructive hydrocephalus and the length of the duration of symptoms.

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“…Late‐onset nerve palsy has been described in other fields of medicine, particularly in neurosurgery. The majority of these observations derive from studies of patients who developed delayed facial nerve palsy after surgery for acoustic neuroma and microvascular decompression surgery for hemifacial spasm. Delayed nerve palsies have also been reported for other cranial nerves.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of these observations derive from studies of patients who developed delayed facial nerve palsy after surgery for acoustic neuroma and microvascular decompression surgery for hemifacial spasm. Delayed nerve palsies have also been reported for other cranial nerves. In a review of 611 patients who underwent surgery for vestibular schwannoma, 13 (2·1 per cent) were diagnosed with late‐onset facial nerve palsy; remarkably, none of these patients recovered fully during follow‐up.…”

Section: Discussionmentioning

confidence: 99%