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The outcome of microvascular decompression for hemifacial spasm: a systematic review and meta-analysis

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Abstract

Microvascular decompression (MVD) is the first choice of surgery for hemifacial spasm (HFS). MVD surgery for vertebral artery (VA)-associated HFS is more difficult than for non-VA-associated HFS. There is controversy about the cure rate and complication of MVD for HFS in previous studies. We searched PubMed, Web of Science, and Embase for relevant publications. Based on the search results, we compared the outcomes of MVD for VA-associated HFS and non-VA-associated HFS. At the same time, we analyzed spasm-free rates and the complications and assessed the relationship between VA-associated HFS and gender, left side, and age. For analysis, six studies that included 2952 patients in the VA-associated group and 604 in the non-VA-associated group were selected. The effective rate of MVD was not significantly different between both groups (OR = 1.16, 95% CI 0.81–1.67, P = 0.42). Compared to non-VA-associated group, the transient complications (OR = 0.64, 95% CI 0.46–0.89, P = 0.008) and permanent complications (OR = 0.28, 95% CI 0.15–0.54, P = 0.0001) occurred more frequently in VA-associated group. The rate of hearing loss was significantly higher in VA-associated HFS than non-VA-associated HFS (OR = 0.35, 95% CI 0.19–0.64, P = 0.0007); the facial paralysis after operation was not significantly different between both groups (OR = 1.25, 95% CI 0.91–1.72, P = 0.17). There were older patients (WMD = 3.67, 95% CI 3.29–4.05, P < 0.00001) and more left-sided HFS (OR = 0.23, 95% CI 0.19 − 0.29, P < 0.0002) in the VA-associated HFS group than non-VA-associated HFS group, while the non-VA-associated HFS group was female-dominated (OR = 1.58, 95% CI 1.32 − 1.89, P < 0.00001). Both groups achieved good results in MVD cure rates. In VA-associated HFS, the complication rate of decompression and the rate of hearing loss after operation were higher than in non-VA-associated HFS, but the facial paralysis after operation was similar in both groups, and most complications were transient and disappeared during follow-up. VA-associated HFS is more prevalent in older adults, less prevalent in women, and more predominantly left-sided. More clinical studies are needed to better compare the efficacy and complication of MVD between both groups.

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The original data used in the study are all included in the article; further inquiries can be directed to the corresponding author.

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References

  1. Sindou M, Mercier P (2018) Microvascular decompression for hemifacial spasm: outcome on spasm and complications. A review. Neuro-Chirurgie 64:106–116. https://doi.org/10.1016/j.neuchi.2018.01.001

    Article  CAS  PubMed  Google Scholar 

  2. Auger RG, Whisnant JP (1990) Hemifacial spasm in Rochester and Olmsted County, Minnesota, 1960 to 1984. Arch Neurol 47:1233–1234. https://doi.org/10.1001/archneur.1990.00530110095023

    Article  CAS  PubMed  Google Scholar 

  3. Tan NC, Chan LL, Tan EK (2002) Hemifacial spasm and involuntary facial movements. QJM 95:493–500. https://doi.org/10.1093/qjmed/95.8.493

    Article  PubMed  Google Scholar 

  4. Dou NN, Zhong J, Zhou QM, Zhu J, Wang YN, Xia L, Yang XS, Ying TT, Zheng XS, Li ST (2015) The mechanism of hemifacial spasm: a new understanding of the offending artery. Neurol Res 37:184–188. https://doi.org/10.1179/1743132814Y.0000000424

    Article  PubMed  Google Scholar 

  5. Green KE, Rastall D, Eggenberger E (2017) Treatment of blepharospasm/hemifacial spasm. Curr Treat Options Neurol 19:41. https://doi.org/10.1007/s11940-017-0475-0

    Article  PubMed  Google Scholar 

  6. Ryu H, Yamamoto S, Sugiyama K, Uemura K, Miyamoto T (1998) Hemifacial spasm caused by vascular compression of the distal portion of the facial nerve. Report of seven cases. J Neurosurg 88:605–609. https://doi.org/10.3171/jns.1998.88.3.0605

    Article  CAS  PubMed  Google Scholar 

  7. Kim JP, Park BJ, Choi SK, Rhee BA, Lim YJ (2008) Microvascular decompression for hemifacial spasm associated with vertebrobasilar artery. J Korean Neurosurg Soc 44:131–135. https://doi.org/10.3340/jkns.2008.44.3.131

    Article  PubMed  PubMed Central  Google Scholar 

  8. Nagahiro S, Takada A, Matsukado Y, Ushio Y (1991) Microvascular decompression for hemifacial spasm. Patterns of vascular compression in unsuccessfully operated patients. J Neurosurg 75:388–392. https://doi.org/10.3171/jns.1991.75.3.0388

    Article  CAS  PubMed  Google Scholar 

  9. Lee S, Han J, Park SK, Lee JA, Joo BE, Park K (2021) Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy. Sci Rep 11:4915. https://doi.org/10.1038/s41598-021-84347-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Mikami T, Minamida Y, Akiyama Y, Wanibuchi M, Sugino T, Houkin K, Mikuni N: (2013) Microvascular decompression for hemifacial spasm associated with the vertebral artery. Neurosurg Rev 36:303–308; discussion 308–309. https://doi.org/10.1007/s10143-012-0425-y

  11. Zhao H, Tang Y, Zhang X, Zhu J, Yuan Y, Zhou P, Li S (2019) Long-term outcomes of microvascular decompression in the treatment of hemifacial spasm based on different offending vessels. J Neurol Surg A Cent Eur Neurosurg 80:285–290. https://doi.org/10.1055/s-0039-1685199

    Article  PubMed  Google Scholar 

  12. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https://doi.org/10.1371/journal.pmed.1000097

    Article  PubMed  PubMed Central  Google Scholar 

  13. Sohani ZN, Meyre D, de Souza RJ, Joseph PG, Gandhi M, Dennis BB, Norman G, Anand SS (2015) Assessing the quality of published genetic association studies in meta-analyses: the quality of genetic studies (Q-Genie) tool. BMC Genet 16:50. https://doi.org/10.1186/s12863-015-0211-2

    Article  PubMed  PubMed Central  Google Scholar 

  14. Thelin GM, Wgner RH (1961) Sedimentation of plasma antihemophilic factor. Arch Biochem Biophys 95:70–76. https://doi.org/10.1016/0003-9861(61)90110-2

    Article  CAS  PubMed  Google Scholar 

  15. Thirumala PD, Altibi AM, Chang R, Saca EE, Iyengar P, Reddy R, Anetakis K, Crammond DJ, Balzer JR, Sekula RF (2020) The Utility of intraoperative lateral spread recording in microvascular decompression for hemifacial spasm: a systematic review and meta-analysis. Neurosurgery 87:E473–E484. https://doi.org/10.1093/neuros/nyaa069

    Article  PubMed  Google Scholar 

  16. Wan X, Wang W, Liu J, Tong T (2014) Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 14:135. https://doi.org/10.1186/1471-2288-14-135

    Article  PubMed  PubMed Central  Google Scholar 

  17. Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558. https://doi.org/10.1002/sim.1186

    Article  PubMed  Google Scholar 

  18. Liu J, Zhu C, Liu R, Liu B, Zhou J, Fan C, Jiao F, Wang D, Wu G, Jiang Y (2020) Clinical analysis of patients with ipsilateral coexistence of hemifacial spasm and trigeminal neuralgia. World Neurosurg 138:e652–e658. https://doi.org/10.1016/j.wneu.2020.03.040

    Article  PubMed  Google Scholar 

  19. Masuoka J, Matsushima T, Nakahara Y, Inoue K, Yoshioka F, Kawashima M, Abe T (2017) Outcome of microvascular decompression for hemifacial spasm associated with the vertebral artery. Neurosurg Rev 40:267–273. https://doi.org/10.1007/s10143-016-0759-y

    Article  PubMed  Google Scholar 

  20. Yang DB, Wang ZM (2017) Microvascular decompression for hemifacial spasm associated with the vertebral artery. Acta Neurol Belg 117:713–717. https://doi.org/10.1007/s13760-017-0766-y

    Article  PubMed  Google Scholar 

  21. Ioli P, Vera J, Femminini R, Gonorazky SE (2004) Arterial hypertension as a risk factor for hemifacial spasm due to vascular compression. Rev Neurol 39:198–199. https://doi.org/10.33588/rn.3902.2003534

    Article  CAS  PubMed  Google Scholar 

  22. Kim JP, Chung JC, Chang WS, Chung SS, Chang JW (2012) Outcomes of surgical treatment for hemifacial spasm associated with the vertebral artery: severity of compression, indentation, and color change. Acta Neurochir 154:501–508. https://doi.org/10.1007/s00701-011-1247-3

    Article  PubMed  Google Scholar 

  23. Omotoso BR, Harrichandparsad R, Satyapal KS, Moodley IG, Lazarus L (2021) Radiological anatomy of the intracranial vertebral artery in a select South African cohort of patients. Sci Rep 11:12138. https://doi.org/10.1038/s41598-021-91744-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Vishal, Kumar H, Medical JJJoEo, Sciences D: (2016) Histological Variations in Various Segments of Vertebral Artery 5

  25. Jeng JS, Yip PK (2004) Evaluation of vertebral artery hypoplasia and asymmetry by color-coded duplex ultrasonography. Ultrasound Med Biol 30:605–609. https://doi.org/10.1016/j.ultrasmedbio.2004.03.004

    Article  PubMed  Google Scholar 

  26. Morssinkhof MWL, van Wylick DW, Priester-Vink S, van der Werf YD, den Heijer M, van den Heuvel OA, Broekman BFP (2020) Associations between sex hormones, sleep problems and depression: a systematic review. Neurosci Biobehav R 118:669–680. https://doi.org/10.1016/j.neubiorev.2020.08.006

    Article  CAS  Google Scholar 

  27. Chen SR (2018) Neurological imaging for hemifacial spasm. Int Ophthalmol Clin 58:97–109. https://doi.org/10.1097/IIO.0000000000000212

    Article  PubMed  Google Scholar 

  28. Mercier P, Sindou M (2018) The conflicting vessels in hemifacial spasm: literature review and anatomical-surgical implications. Neurochirurgie 64:94–100. https://doi.org/10.1016/j.neuchi.2018.01.004

    Article  CAS  PubMed  Google Scholar 

  29. Jiang C, Liang W, Wang J, Dai Y, Jin W, Sun X, Xu W (2020) Microvascular decompression for hemifacial spasm associated with distinct offending vessels: a retrospective clinical study. Clin Neurol Neurosurg 194:105876. https://doi.org/10.1016/j.clineuro.2020.105876

    Article  PubMed  Google Scholar 

  30. Kim JY, Jung S, Song TW, Kim IY, Moon KS, Jung TY, Jang WY (2019) The cornerstone technique of microvascular decompression for hemifacial spasm with vertebral artery offender. World Neurosurg 126:e94–e100. https://doi.org/10.1016/j.wneu.2019.01.199

    Article  PubMed  Google Scholar 

  31. Xue F, Shen Z, Wang Y, Kwok SC, Yin J (2021) Microvascular decompression for hemifacial spasm involving the vertebral artery: a modified effective technique using a gelatin sponge with a FuAiLe medical adhesive. CNS Neurosci Ther 27:857–861. https://doi.org/10.1111/cns.13662

    Article  PubMed  PubMed Central  Google Scholar 

  32. Zhang X, Zhao H, Zhu J, Tang Y, Ying T, Yuan Y, Li S (2017) Outcome of biomedical glue sling technique in microvascular decompression for hemifacial spasm involving the vertebral artery. World Neurosurg 104:186–191. https://doi.org/10.1016/j.wneu.2017.04.048

    Article  PubMed  Google Scholar 

  33. Xu ZH, Tang YS, Yan YH (2018) Clinical analysis on hemifacial spasm treated by microvascular decompression. Chinese J Contemp Neurol Neurosurg 18:754–757. https://doi.org/10.3969/j.issn.1672-6731.2018.10.012

    Article  Google Scholar 

  34. Zhao Z, Chai S, Xiao D, Zhou Y, Gan J, Jiang X, Zhao H (2021) Microscopic versus endoscopic microvascular decompression for the treatment of hemifacial spasm in China: a meta-analysis and systematic review. J Clin Neurosci 91:23–31. https://doi.org/10.1016/j.jocn.2021.06.034

    Article  PubMed  Google Scholar 

  35. Feng BH, Zhong WX, Li ST, Wang XH (2020) Fully endoscopic microvascular decompression of the hemifacial spasm: our experience. Acta Neurochir 162:1081–1087. https://doi.org/10.1007/s00701-020-04245-5

    Article  PubMed  Google Scholar 

  36. Flanders TM, Blue R, Roberts S, McShane BJ, Wilent B, Tambi V, Petrov D, Lee JYK (2018) Fully endoscopic microvascular decompression for hemifacial spasm. J Neurosurg 131:813–819. https://doi.org/10.3171/2018.4.JNS172631

    Article  PubMed  Google Scholar 

  37. Matmusaev M, Kumar RS, Yamada Y, Nagatani T, Kawase T, Tanaka R, Kyosuke M, Kato Y (2020) Endoscopic microvascular decompression for hemifacial spasm. Asian J Neurosurg 15:833–838. https://doi.org/10.4103/ajns.AJNS_152_20

    Article  PubMed  PubMed Central  Google Scholar 

  38. Huang BR, Chang CN, Hsu JC (2009) Intraoperative electrophysiological monitoring in microvascular decompression for hemifacial spasm. J Clin Neurosci 16:209–213. https://doi.org/10.1016/j.jocn.2008.04.016

    Article  PubMed  Google Scholar 

  39. Sindou M, Mercier P (2018) Microvascular decompression for hemifacial spasm : surgical techniques and intraoperative monitoring. Neurochirurgie 64:133–143. https://doi.org/10.1016/j.neuchi.2018.04.003

    Article  CAS  PubMed  Google Scholar 

  40. Zhu W, Sun C, Zhang Y, Xu J, Wu S (2020) AMR monitoring in microvascular decompression for hemifacial spasm: 115 cases report. J Clin Neurosci 73:187–194. https://doi.org/10.1016/j.jocn.2019.10.008

    Article  PubMed  Google Scholar 

  41. Nonaka Y, Hayashi N, Matsumae M, Fukushima T (2019) Wedge-technique for transposition of the vertebral artery in microvascular decompression for hemifacial spasm: technical nuances and surgical outcomes. Acta Neurochir 161:1435–1442. https://doi.org/10.1007/s00701-018-03793-1

    Article  PubMed  Google Scholar 

  42. Otani N, Toyooka T, Takeuchi S, Tomiyama A, Wada K, Mori K (2018) Novel technical variations and increased adhesive strength in the ”birdlime” transposition technique for microvascular decompression. World Neurosurg 116:e460–e468. https://doi.org/10.1016/j.wneu.2018.05.006

    Article  PubMed  Google Scholar 

  43. Zhang X, Kang X, Jiang Q, Zhao H, Tang Y, Zhu J, Zhou P, Yuan Y, Li S (2018) Efficacy of biomedical glue sling technique versus traditional technique for microvascular decompression for hemifacial spasm with refractory hypertension. World Neurosurg 110:E473–E478. https://doi.org/10.1016/j.wneu.2017.11.022

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors are grateful to the authors of the included studies and the enrolled patients.

Funding

This study was supported by the Foundation of Science and Technology Department of Sichuan Province (Grant No. 2018SZ0179) and the National Natural Science Foundation of China (grant number. 81802096).

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Authors and Affiliations

  1. Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, Guoxue Alley, No. 37, Chengdu, 610041, China

    Jianguo Li, Liang Lyu, Cheng Chen, Senlin Yin, Shu Jiang & Peizhi Zhou

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  1. Jianguo Li
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  2. Liang Lyu
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  3. Cheng Chen
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  4. Senlin Yin
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  5. Shu Jiang
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  6. Peizhi Zhou
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Contributions

Shu Jiang and Jianguo Li conceptualized the study. Senlin Yin and Peizhi Zhou co-developed a designation. Jianguo Li, Liang Lyu, and Cheng Chen extracted the data; Senlin Yin checked the data. Jianguo Li analyzed the data and drafted the manuscript. All the authors interpreted the results and revised the manuscript.

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Correspondence to Peizhi Zhou.

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Li, J., Lyu, L., Chen, C. et al. The outcome of microvascular decompression for hemifacial spasm: a systematic review and meta-analysis. Neurosurg Rev 45, 2201–2210 (2022). https://doi.org/10.1007/s10143-022-01739-x

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