Hemifacial Spasm: Intraoperative Electromyographic Monitoring as a Guide for Microvascular Decompression

Mooij, Jja; Mustafa, M K; Weerden, TW van

doi:10.1097/00006123-200112000-00012

Cited by 73 publications

(54 citation statements)

References 25 publications

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“…All studies in the English-language literature (searched with Ovid Medline) with > 30 patients, containing data on the presence or absence of the AMR at the conclusion of MVD and presence or absence of spasms at followup were included. 3,6,7,9,11,12,21,27,31 In these series, patients in whom the AMR disappeared during dural opening or manipulation of the cerebellum were discarded from analysis. Mooij et al 24 presented their data in an intuitive fashion.…”

Section: Resultsmentioning

confidence: 99%

“…Typical HFS occurs much more frequently than atypical HFS. 8 Intraoperative EMG has been used increasingly in the surgical management of HFS.17 While several retrospective and prospective studies have strongly supported its use, 6,21,27,31 several other studies have failed to show that intraoperative EMG improves outcome (that is, a cure of HFS). 1,3,9,11,28 To date, there are no reported randomized controlled trials of intraoperative EMG that were designed or powered to study cure of HFS as the primary end point.…”

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confidence: 99%

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Utility of intraoperative electromyography in microvascular decompression for hemifacial spasm: a meta-analysis

Sekula

Bhatia²,

Frederickson³

et al. 2009

FOC

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Object In this paper, the authors' goal was to determine the utility of monitoring the abnormal muscle response (AMR) or “lateral spread” during microvascular decompression surgery for hemifacial spasm. Methods The authors' experience with AMR as well as the data available in the English-language literature regarding resolution or persistence of AMR and the resolution or persistence of hemifacial spasm at follow-up was pooled and subjected to a meta-analysis. Results The pooled OR revealed by the meta-analysis was 4.2 (95% CI 2.7–6.7). The chance of a cure if the AMR was abolished during surgery was 4.2 times greater than if the lateral spread persisted. Conclusions The AMR should be monitored routinely in the operating room, and surgical decision-making in the operating room should be augmented by the AMR.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Utility of intraoperative electromyography in microvascular decompression for hemifacial spasm: a meta-analysis

Sekula

Bhatia²,

Frederickson³

et al. 2009

FOC

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“…Mooij ve ark. [15] ise HFS nedeniyle ameliyat ettikleri hastalarda dekompresyonun yeterliliğini belirlemek için ameliyat sırası EMG kullanmış ve %87 hastada faydalı olduğunu belirtmişlerdir.…”

Section: Discussionunclassified

Vascular compression syndromes: our 24 year endoscope-assisted microvascular decompression experiences

Tutar

Şahin²,

Tutar³

et al. 2014

Kulak Burun Bogaz Ihtis Derg

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Amaç: Bu çalışmada hemifasiyal spazm, trigeminal nevralji, kokleovestibüler sinir kompresyonu gibi vasküler kompresyon sendromları nedeniyle yapılan endoskop yardımlı mikrovasküler dekompresyon deneyimlerimiz sunuldu. Hastalar ve Yöntemler:Mart 1999 -Haziran 2013 tarihleri arasında kliniğimizde vasküler kompresyon sendromları nedeniyle 55 hastaya (34 kadın, 21 erkek; ort. yaş 44 yıl; dağılım 24-77 yıl) endoskop yardımlı retrosigmoid yaklaşımla mikrosvasküler dekompresyon ameliyatı uygulandı. Tanı öykü, nörolojik muayene, manyetik rezonans görüntüleme bulguları ve odyovestibüler testler ile konuldu. Bulgular:Toplam 49 hastada (%89.1) tam iyileşme, iki hastada (%3.6) kısmi iyileşme, dört hastada (%7.3) ise semptomlarda düzelmeme görüldü. Sadece iki (%3.6) hastada ameliyat sırası komplikasyon olarak beyin omurilik sıvısı kaçağı gelişti. En sık bası yapan damarsal yapı ön ve alt serebellar arter olup, 14 hastada gözlendi. Esansiyel hipertansiyonlu dört hasta eş zamanlı sol medulla oblongata basısı dekomprese edildikten sonra normotansif oldu. Sonuç:Mikrovasküler kompresyon ameliyatı ile vasküler kompresyon sendromlu hastaların semptomlarında anlamlı iyileşme sağlanır. Ameliyat mikroskobuna yardımcı olarak açılı teleskopların kullanılması kraniyal sinire root entry zone bölgesinde bası nedenini saptamada önemli yardım sağlamaktadır.Anahtar Sözcükler: Endoskop yardımlı retrosigmoid yaklaşım; arka kraniyal fossa; retrosigmoid yaklaşım; root entry zone; vasküler kompresyon sendromları.Objectives: This study aims to report our experience on endoscope-assisted microvascular decompression experiences performed due to vascular compression syndromes such as hemifacial spasm, trigeminal neuralgia, and cochleovestibular nerve compression. Patients and Methods:Between March 1999 and June 2013, 55 patients (34 females, 21 males; mean age 44 years; range 24 to 77 years) underwent endoscope-assisted microvascular decompression surgery through a retrosigmoid approach due to vascular compression syndromes in our clinic. The diagnosis was based on history, neurological examination, magnetic resonance imaging findings and audio-vestibular tests.Results: A total of 49 patients (89.1%) had complete relief of the symptoms and two had (3.6%) a partial relief, while four had (7.3%) no relief of the symptoms. Only two patients had (3.6%) cerebrospinal fluid leakages as a perioperative complication. The major offending vessels were anterior and inferior cerebellar arteries in 14 patients. Four patients with essential hypertension became normotensive after decompression of the left medulla oblongata as well. Conclusion:Microvascular decompression surgery provides a significant relief of the symptoms in patients with vascular compression syndromes. An angled endoscope as an adjunct to microscope contributes to the diagnosis of the offending vessel in the root entry zone of the cranial nerve.

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“…They advocated routine intraoperative EMG recording of LSR during MVD, to ensure that adequate decompression was achieved. Mooij et al demonstrated that a guiding role of Intraoperative monitoring was apparent in 33.8% of patients, and a confirming role was demonstrated in 52.7% of patients, which showed that facial EMG can be useful as an aid in the "learning curve" as well as in guiding even the experienced neurosurgeon to obtain the best results 54) . However, Hatem and Sindou et al documented that the persistence of LSR did not necessarily indicate postoperative residual spasm In their study of 30 cases 24) .…”

Section: Intra-operative Monitoring Of the Facial Emg Responsesmentioning

confidence: 98%

Hemifacial Spasm: A Neurosurgical Perspective

Kong

Park

2007

J Korean Neurosurg Soc

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Hemifacial spasm (HFS) is characterized by tonic clonic contractions of the muscles innervated by the ipsilateral facial nerve. Compression of the facial nerve by an ectatic vessel is widely recognized as the most common underlying etiology. HFS needs to be differentiated from other causes of facial spasms, such as facial tic, ocular myokymia, and blepharospasm. To understand the overall craniofacial abnormalities and to perform the optimal surgical procedures for HFS, we are to review the prevalence, pathophysiology, differential diagnosis, details of each treatment modality, usefulness of brainstem auditory evoked potentials monitoring, debates on the facial EMG, clinical course, and complications from the literature published from 1995 to the present time.

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Hemifacial Spasm: Intraoperative Electromyographic Monitoring as a Guide for Microvascular Decompression

Abstract: This study demonstrates the applicability and usefulness of intraoperative facial nerve monitoring in microvascular decompression operations for HFS.

Cited by 73 publications

References 25 publications

Utility of intraoperative electromyography in microvascular decompression for hemifacial spasm: a meta-analysis

Utility of intraoperative electromyography in microvascular decompression for hemifacial spasm: a meta-analysis

Vascular compression syndromes: our 24 year endoscope-assisted microvascular decompression experiences

Hemifacial Spasm: A Neurosurgical Perspective

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