Skip to main content
SpringerLink
Log in

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

  • Original Article - Functional Neurosurgery - Movement disorders
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Microvascular decompression (MVD) is a useful treatment for hemifacial spasm (HFS), but the postoperative course is extremely diverse. The purpose of this study was to compare short- and long-term outcomes, find the earliest optimal time for determining the long-term outcomes, and investigate the prognostic factors involved in the outcomes over time.

Methods

From July 2004 to January 2015, 1341 patients who underwent MVD for HFS were enrolled. Information on clinical features, operative findings, and surgical outcomes over time were collected by performing a review of electronic medical records, and their relationships were analyzed. The outcomes of MVD at 1, 3, 6, and 9 months were individually compared against those at > 12 months after surgery.

Results

The mean follow-up period after surgery was 44.9 months (median, 36.8 months; range, 12.0–156.6 months). The overall improvement rate for the 1341 patients was 89.0%. Individual postoperative outcomes at 6 and 9 months showed no differences with those at > 12 months after surgery. Furthermore, in the uni- and multi-variable analyses, patients in whom the offending vessels were intraoperatively determined to be veins showed bad outcomes at 6, 9, and > 12 months (p = 0.048, p = 0.004, and p = 0.003, respectively). Patients with intraoperative indentation on the facial nerve showed good outcomes at 6, 9, and > 12 months (p = 0.005, p = 0.039, and p = 0.020, respectively). Patients with delayed facial palsy after surgery showed better outcomes at 6, 9, and > 12 months (p = 0.002, p = 0.003, and p = 0.028, respectively).

Conclusions

Short- and long-term outcomes of MVD in patients with HFS manifested differently, but the outcomes at 6 and 9 months showed similarities with those at > 12 months. In patients in whom the intraoperatively detected offending vessel was not a vein, and in patients with intraoperative indentation on the facial nerve and postoperative delayed facial palsy, good outcomes could be predicted after 6 months of surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Chang WS, Chung JC, Kim JP, Chung SS, Chang JW (2012) Delayed recurrence of hemifacial spasm after successful microvascular decompression: follow-up results at least 5 years after surgery. Acta Neurochir 154:1613–1619

    Article  PubMed  Google Scholar 

  2. Cheng J, Fang Y, Zhang H, Lei D, Wu W, You C, Mao B, Mao K (2015) Quantitative study of posterior fossa crowdedness in hemifacial spasm. World Neurosurg 84:920–926

    Article  PubMed  Google Scholar 

  3. Jin Y, Zhao C, Su S, Zhang X, Qiu Y, Jiang J (2015) Residual hemifacial spasm after microvascular decompression: prognostic factors with emphasis on preoperative psychological state. Neurosurg Rev 38:567–572 discussion 572

    Article  PubMed  Google Scholar 

  4. Jo KW, Kong DS, Park K (2013) Microvascular decompression for hemifacial spasm: long-term outcome and prognostic factors, with emphasis on delayed cure. Neurosurg Rev 36:297–301 discussion 301-292

    Article  PubMed  Google Scholar 

  5. Kim HR, Rhee DJ, Kong DS, Park K (2009) Prognostic factors of hemifacial spasm after microvascular decompression. J Korean Neurosurg Soc 45:336–340

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lee JA, Jo KW, Kong DS, Park K (2012) Using the new clinical grading scale for quantification of the severity of hemifacial spasm: correlations with a quality of life scale. Stereotact Funct Neurosurg 90:16–19

    Article  PubMed  Google Scholar 

  7. Lee JM, Park HR, Choi YD, Kim SM, Jeon B, Kim HJ, Kim DG, Paek SH (2018) Delayed facial palsy after microvascular decompression for hemifacial spasm: friend or foe? J Neurosurg 129:299–307

    Article  PubMed  Google Scholar 

  8. Lee JA, Kim KH, Kong DS, Lee S, Park SK, Park K (2019) Algorithm to predict the outcome of microvascular decompression for hemifacial spasm: a data-mining analysis using a decision tree. World Neurosurg 125:e797–e806. https://doi.org/10.1016/j.wneu.2019.01.172

    Article  PubMed  Google Scholar 

  9. Lefaucheur JP (2018) New insights into the pathophysiology of primary hemifacial spasm. Neurochirurgie 64:87–93

    Article  PubMed  Google Scholar 

  10. Li S, Feng B, Xie C, You C, Wei X, Zheng X (2016) Good surgical outcomes of hemifacial spasm patients with obvious facial nerve indentation and color change. World Neurosurg 92:218–222

    Article  PubMed  Google Scholar 

  11. Li Z, Gao J, Wang T, Li Y (2018) Retrospective clinical analysis of 320 cases of microvascular decompression for hemifacial spasm. Medicine (Baltimore) 97:e11825

    Article  Google Scholar 

  12. Liu LX, Zhang CW, Ren PW, Xiang SW, Xu D, Xie XD, Zhang H (2016) Prognosis research of delayed facial palsy after microvascular decompression for hemifacial spasm. Acta Neurochir 158:379–385

    Article  PubMed  Google Scholar 

  13. Lv MY, Deng SL, Long XF, Liu ZL (2017) Long-term outcome of microvascular decompression for hemifacial spasm. Br J Neurosurg 31:322–326

    Article  PubMed  Google Scholar 

  14. Miller LE, Miller VM (2012) Safety and effectiveness of microvascular decompression for treatment of hemifacial spasm: a systematic review. Br J Neurosurg 26:438–444

    Article  PubMed  Google Scholar 

  15. Montava M, Rossi V, CurtoFais CL, Mancini J, Lavieille JP (2016) Long-term surgical results in microvascular decompression for hemifacial spasm: efficacy, morbidity and quality of life. Acta Otorhinolaryngol Ital 36:220–227

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Park JS, Kong DS, Lee JA, Park K (2008) Hemifacial spasm: neurovascular compressive patterns and surgical significance. Acta Neurochir 150:235–241 discussion 241

    Article  CAS  PubMed  Google Scholar 

  17. Shah A, Horowitz M (2017) Persistent hemifacial spasm after microvascular decompression: a risk assessment model. Br J Neurosurg 31:327–335

    Article  PubMed  Google Scholar 

  18. Sindou M, Mercier P (2018) Microvascular decompression for hemifacial spasm: outcome on spasm and complications. A review. Neurochirurgie 64:106–116

    Article  CAS  PubMed  Google Scholar 

  19. Terasaka S, Asaoka K, Yamaguchi S, Kobayashi H, Motegi H, Houkin K (2016) A significant correlation between delayed cure after microvascular decompression and positive response to preoperative anticonvulsant therapy in patients with hemifacial spasm. Neurosurg Rev 39:607–613

    Article  PubMed  Google Scholar 

  20. Toda H, Iwasaki K, Yoshimoto N, Miki Y, Hashikata H, Goto M, Nishida N (2018) Bridging veins and veins of the brainstem in microvascular decompression surgery for trigeminal neuralgia and hemifacial spasm. Neurosurg Focus 45:E2

    Article  PubMed  Google Scholar 

  21. Wang X, Thirumala PD, Shah A, Gardner P, Habeych M, Crammond D, Balzer J, Burkhart L, Horowitz M (2013) The role of vein in microvascular decompression for hemifacial spasm: a clinical analysis of 15 cases. Neurol Res 35:389–394

    Article  CAS  PubMed  Google Scholar 

  22. Xia L, Zhong J, Zhu J, Dou NN, Liu MX, Li ST (2015) Delayed relief of hemifacial spasm after microvascular decompression. J Craniofac Surg 26:408–410

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro Gangnam-gu, Seoul, 06351, South Korea

    Jeong-A Lee & Kwan Park

Authors
  1. Jeong-A Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kwan Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kwan Park.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Institutional Review Board of Samsung Medical Center/SMC 2015-12-102) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Functional Neurosurgery - Movement disorders

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, JA., Park, K. Short-term versus long-term outcomes of microvascular decompression for hemifacial spasm. Acta Neurochir 161, 2027–2033 (2019). https://doi.org/10.1007/s00701-019-04032-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-019-04032-x

Keywords

Search

Navigation