Frequency and prognosis of delayed facial palsy after microvascular decompression for hemifacial spasm

Rhee, Deok-Joo; Kong, Doo Sik; Park, K.; Lee, J. A.

doi:10.1007/s00701-006-0847-9

Cited by 48 publications

(48 citation statements)

References 11 publications

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“…The major postoperative complications included permanent hearing loss in 6 (1.8%), immediate facial weakness in 4 (1.4%), delayed facial weakness in 6 (2.0%), and cerebrospinal fluid leakage in 1 (0.3%). One patient with delayed facial palsy had spontaneous symptom improvement 19) . There was neither death nor ischemic insults in our series.…”

Section: Resultsmentioning

confidence: 96%

Prognostic Factors of Hemifacial Spasm after Microvascular Decompression

Kim

Rhee

Kong

et al. 2009

J Korean Neurosurg Soc

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Objective : The factors that influence the prognosis of patients with hemifacial spasm (HFS) treated by microvascular decompression (MVD) have not been definitely established. We report a prospective study evaluating the prognostic factors in patients undergoing MVD for HFS. Methods : From January 2004 to September 2006, the authors prospectively studied a series of 293 patients who underwent MVD for HFS. We prospectively analyzed a number of variables in order to evaluate the predictive value of independent variables for the prognosis of patients undergoing MVD. The patients were followed-up at regular intervals and divided into as cured and unsatisfactory groups based on symptom relief. Uni-and multivariate analyses were performed using logistic regression models. Results : A total 273 of 293 (94.2%) patients achieved symptom relief within one year after the operation. Intraoperatively, the indentation of the root exit zone was observed in 259 (88.5%) patients. Uni-and multivariate analyses revealed that the symptoms at postoperative 3 months (p<0.001) and indentation of the root exit zone (p=0.036) were associated with good outcomes. Conclusion :The intraoperative finding of root exit zone indentation will help physicians determine the prognosis in patients with HFS. To predict the prognosis of HFS, a regular follow-up period of at least 3 months following MVD should be required.

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Section: Resultsmentioning

confidence: 96%

Prognostic Factors of Hemifacial Spasm after Microvascular Decompression

Kim

Rhee

Kong

et al. 2009

J Korean Neurosurg Soc

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“…In table 3, we compared the clinical results of our patients with previously reported results of DFP patients who underwent MVD for HFS. Although facial spasm completely disappeared after MVD, delayed facial weakness may decrease the patient’s individual satisfaction [1,5,7,38,39,40]. With delayed facial weakness after surgery, relevant explanations have been introduced including reactivation of HSV, delayed facial nerve edema due to unwanted inflammation, and microcirculation disruptions due to an ischemic result.…”

Section: Discussionmentioning

confidence: 99%

“…DFP shows a rather sudden onset, and it usually occurs more than 24 h after the operation [1]. Some authors have reported that the rate developing DFP following MVD is 2.8–8.3% [2,3,4].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Facial Electromyography and Brainstem Auditory Evoked Potential Findings in Microvascular Decompression for Hemifacial Spasm: Correlation with Postoperative Delayed Facial Palsy

Kim

Park

Ryu³

et al. 2012

Stereotact Funct Neurosurg

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Background: Delayed facial palsy (DFP) after microvascular decompression (MVD) in patients with hemifacial spasm (HFS) is not uncommon, but the cause remains unknown. Objectives: To assess whether intraoperative electromyography (EMG) and brainstem auditory evoked potential (BAEP) can predict DFP after MVD. Methods: Between September 2009 and February 2011 we examined 86 patients, 9 of whom (10.4%) developed DFP after MVD on the same side. All patients underwent MVD and were followed-up for a median period of 13 months (range 6–22). We retrospectively examined intraoperative facial EMG and BAEP findings using our MVD patients’ registry. We excluded secondary HFS and immediate postoperative facial palsy after MVD in this study. We assessed the prevalence and clinical characteristics of DFP and compared EMG and BAEP findings between DFP and non-DFP groups. Results: All patients recovered completely, with a mean time to recovery of 37.8 days (range 22–57). There were no significant differences between DFP and non-DFP patients in terms of the amplitude and latency of intraoperative EMG and BAEP. Conclusion: The usefulness of intraoperative facial EMG and BAEP is limited and cannot predict DFP after MVD for HFS. We speculate that DFP after MVD is not associated with permanent nerve damage according to the EMG findings.

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“…Among them, delayed facial palsy (DFP) reported most commonly. Several reports describe an incidence of DFP following MVD in HFS of 2.8-8.3%10,14,15,20). The purpose of this study was to evaluate the incidence of delayed cranial nerve (VI, VII, and VIII ) palsy following MVD and its clinical courses.…”

Section: Introductionmentioning

confidence: 97%

Delayed Cranial Nerve Palsy after Microvascular Decompression for Hemifacial Spasm

Han

Lee

Kong

et al. 2012

J Korean Neurosurg Soc

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ObjectiveMicrovascular decompression (MVD) for hemifacial spasm (HFS) is a safe and effective treatment with favorable outcomes. The purpose of this study was to evaluate the incidence of delayed cranirve ( VI, VII, and VIII ) palsy following MVD and its clinical courses.MethodsBetween January 1998 and December 2009, 1354 patients underwent MVD for HFS at our institution. Of them, 100 patients (7.4%) experienced delayed facial palsy (DFP), one developed sixth nerve palsy, and one patient had delayed hearing loss.ResultsDFP occurred between postoperative day number 2 and 23 (average 11 days). Ninety-two patients (92%) completely recovered; however, House-Brackmann grade II facial weakness remained in eight other patients (8%). The time to recovery averaged 64 days (range, 16 days to 9 months). Delayed isolated sixth nerve palsy recovered spontaneously without any medical or surgical treatment after 8 weeks, while delayed hearing loss did not improve.ConclusionDelayed cranial nerve (VI, VII, and VIII) palsies can occur following uncomplicated MVD for HFS. DFP is not an unusual complication after MVD, and prognosis is fairly good. Delayed sixth nerve palsy and delayed hearing loss are extremely rare complications after MVD for HFS. We should consider the possibility of development of these complications during the follow up for MVD.

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Frequency and prognosis of delayed facial palsy after microvascular decompression for hemifacial spasm

Cited by 48 publications

References 11 publications

Prognostic Factors of Hemifacial Spasm after Microvascular Decompression

Prognostic Factors of Hemifacial Spasm after Microvascular Decompression

Intraoperative Facial Electromyography and Brainstem Auditory Evoked Potential Findings in Microvascular Decompression for Hemifacial Spasm: Correlation with Postoperative Delayed Facial Palsy

Delayed Cranial Nerve Palsy after Microvascular Decompression for Hemifacial Spasm

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