Long-term outcome of microvascular decompression for hemifacial spasm

Lv, Mingyi; Deng, Shu-Ling; Long, Xiaofeng; Liu, Zengliang

doi:10.1080/02688697.2017.1297368

Cited by 30 publications

(11 citation statements)

References 33 publications

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“…Although the surgical outcomes did not differ between the severe- and mild-spasm groups in our study, the degree of indentation and multiple offenders could be important because many previous studies have found these surgical findings to be associated with surgical outcome. 11 12 13 33 Moreover, indentation has been reported to be associated with delayed facial palsy and disease duration, 34 and we also found that HFS severity was independently related to disease duration, indentation degree, multiple offending vessels, and delayed facial palsy. Based on our results, spasm severity could be regarded as a biomarker of the degree of pathologic compression in patients with HFS.…”

Section: Discussionsupporting

confidence: 70%

“…Although many previous studies have examined predictors of the prognosis of HFS after MVD, they predominantly investigated intraoperative findings rather than clinical features. 10 11 12 13 Unlike previous studies, we focused on the clinical characteristics of HFS. Our reasoning was that the treatment modality should be decided based on both clinical features and intraoperative findings.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few clinical characteristics of HFS have been reported previously and no consensus has been reached, 9 10 11 while various surgical findings including intraoperative severity of indentation or resolution of the lateral spread response were suggested to be related to surgical outcome. 10 11 12 13 It is particularly notable that the severity of HFS is a clinical barometer that can be easily assessed in a clinic, but there is no consensus on how to evaluate spasm severity. We previously proposed the Samsung Medical Center (SMC, Seoul, Korea) grading system as a tool for evaluating HFS severity, and found that spasm severity was strongly correlated with quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Severe Hemifacial Spasm is a Predictor of Severe Indentation and Facial Palsy after Microdecompression Surgery

Cho

Park

et al. 2018

J Clin Neurol

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Background and PurposeHemifacial spasm (HFS) is mostly caused by the compression of the facial nerve by cerebral vessels, but the significance of spasm severity remains unclear. We investigated the clinical significance of spasm severity in patients with HFS who underwent microvascular decompression (MVD).MethodsWe enrolled 636 patients with HFS who underwent MVD between May 2010 and December 2013 at Samsung Medical Center (SMC), Seoul, Korea. Subjects were divided into two groups based on spasm severity: severe (SMC grade 3 or 4) and mild (SMC grade 1 or 2). We compared demographic, clinical, and surgical data between these two groups.ResultsThe severe-spasm group was older and had a longer disease duration at the time of MVD compared to the mild-spasm group. Additionally, hypertension and diabetes mellitus were more common in the severe-spasm group than in the mild-spasm group. Regarding surgical findings, there were more patients with multiple offending vessels and more-severe indentations in the severe-spasm group than in the mild-spasm group. Even though the surgical outcomes did not differ, the incidence of delayed facial palsy after MVD was higher in the severe-spasm group than in the mild-spasm group. Logistic regression analysis showed that severe-spasm was correlated with longer disease duration, hypertension, severe indentation, multiple offending vessels, and delayed facial palsy after MVD.ConclusionsSpasm severity does not predict surgical outcomes, but it can be used as a marker of pathologic compression in MVD for HFS, and be considered as a predictor of delayed facial palsy after MVD.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Severe Hemifacial Spasm is a Predictor of Severe Indentation and Facial Palsy after Microdecompression Surgery

Cho

Park

et al. 2018

J Clin Neurol

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“…The prevalence of other cranial neuralgias is lower than that of TN. The prevalence of hemifacial spasm is 0.83 per 100,000 patients and that of glossopharyngeal neuralgia is 0.7 per 100,000 people . Clinical results suggest that the benefit of MVD lasts longer in these neuralgias than in TN as well.…”

Section: Introductionmentioning

confidence: 98%

“…Clinical results suggest that the benefit of MVD lasts longer in these neuralgias than in TN as well. In Japan, 6‐year follow‐up data after MVD for hemifacial spasm showed that 87% of patients continued to have meaningful effects from surgery . Similarly, 12‐year post‐MVD data for treatment of glossopharyngeal neuralgia showed that 28 of 29 patients continued to have lasting treatment effect …”

Section: Introductionmentioning

confidence: 99%

Nationwide Shift From Percutaneous Rhizotomy to Microvascular Decompression for Treatment of Trigeminal and Other Cranial Nerve Neuralgias

Kundu

Rolston

2018

Headache

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Objective The aim of this study was to report the trends in the use of common surgical interventions over the past decade to treat cranial nerve neuralgias. Methods The Centers for Medicare and Medicaid Services Part B National Summary Data File from 2000 to 2016 were studied. Results A total of 57.1 million persons were enrolled in 2016, up from 39.6 million persons in 2000. Suboccipital craniectomy done for cranial nerve decompressions (including cranial nerves V, VII, and IX) increased by 33.9 cases per year so that in 2016 the number of cases was 167% of what it was 17 years earlier (ie, from 655 cases in 2000 to 1096 cases in 2016). The less commonly used subtemporal approach craniectomy to treat trigeminal neuralgia (TN) increased by 1.13 cases per year (ie, from 25 cases in 2000 to 46 cases in 2016). The less invasive percutaneous rhizotomy procedures, including glycerol and radiofrequency ablation, for treatment of TN decreased by 42.9 cases per year (64%; ie, from 2578 cases in 2000 to 1206 cases in 2016). Conclusions Overall trends show increased use of open surgery and decreased use of percutaneous rhizotomy, including destruction of the trigeminal nerve using balloon compression, glycerol injection, or thermal injury. These trends may be related to differences in outcomes between treatment modalities.

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Short-term versus long-term outcomes of microvascular decompression for hemifacial spasm

Lee

Park

2019

Acta Neurochir

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Long-term outcome of microvascular decompression for hemifacial spasm

Cited by 30 publications

References 33 publications

Severe Hemifacial Spasm is a Predictor of Severe Indentation and Facial Palsy after Microdecompression Surgery

Severe Hemifacial Spasm is a Predictor of Severe Indentation and Facial Palsy after Microdecompression Surgery

Nationwide Shift From Percutaneous Rhizotomy to Microvascular Decompression for Treatment of Trigeminal and Other Cranial Nerve Neuralgias

Short-term versus long-term outcomes of microvascular decompression for hemifacial spasm

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