Abstract
Background
Microvascular decompression (MVD) for hemifacial spasm (HFS) has been popular, but it may take enough time to master this special operative technique and procedure. This may induce uneven distribution of the number of MVD operations in each institute, possibly resulting in an overall unsatisfactory quality of MVD surgeons. Nakanishi’s approach to MVD operations has the feature of using a, “supine, no retractor” technique, which would achieve various benefits for patients and medical professionals. We would like to recommend this approach for MVD surgeons on the basis of our follow-up outcomes.
Methods
A questionnaire, which was based on the method of evaluation for the long-term results of post-MVD operation as recommended by the Japanese Society of MVD, was sent by mail to the 154 HFS patients who had received Nakanishi’s approach at our hospital.
Results
Except for 42 patients who had changed their residences, 89 patients (79.5 % of 112) fully answered. The mean postoperative follow-up term was 13.0 years. The 76.4 % of the patients was estimated as excellent. Postoperative deafness was not present. The average value of satisfaction degree for the results of the MVD operation was 87.9 %.
Conclusions
This study revealed that Nakanishi’s approach produced good results equivalent of other approaches for HFS patients. This approach is considered to have many advantages comparing to the other approaches. Therefore, we would like to recommend that Nakanishi’s approach would contribute to overall advancement of the level of MVD surgeons.
Similar content being viewed by others
References
Barker FG, Jannetta PJ, Bissonette DJ, Shields PT, Larkins MV, Jho HD (1995) Microvascular decompression for hemifacial spasm. J Neurosurg 82:201–210
Cheney FW, Domino KB, Caplan RA, Posner KL (1999) Nerve injury associated with anesthesia. Anesthesiology 90:1062–1069
Coonan TJ, Hope CE (1983) Cardio-respiratory effects of change of body position. Can Anaesth Soc J 30:424–437
Dannenbaum M, Lega BC, Suki D, Harper RL, Yoshor D (2008) Microvascular decompression for hemifacial spasm: long-term results from 114 operations performed without neurophysiological monitoring. J Neurosurg 109:410–415
Hitotsumatsu T, Matsushima T, Inoue T (2003) Microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: three surgical approach variations: technical note. Neurosurgery 53:1436–1443
Illingworth RD, Porter DG, Jakubowski J (1996) Hemifacial spasm: a prospective long term follow up of 83 cases treated by microvascular decompression at two neurosurgical centres in the United Kingdom. J Neurol Neurosurg Psychiatry 60:72–77
Ishikawa M, Nakanishi T, Takamiya Y, Namiki J (2001) Delayed resolution of residual hemifacial spasm after microvascular decompression operations. Neurosurgery 49:847–856
Jannetta PJ (1982) Treatment of trigeminal neuralgia by microoperative decompression. In: Youmans JR (ed) Neurological Surgery, vol 6, 2nd edn. W.B. Saunders Co, Philadelphia, pp 3589–3603
Kondo A (1997) Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm. Neurosurgery 40:46–52
Kondo A (2010) A proposal for standardizing the results of microvascular decompression surgery. Jpn J Neurosurg (Tokyo) 19:691–695
Little AS, Shetter AG, Shetter ME, Bay C, Rogers CL (2008) Long-term pain response and quality of life in patients with typical trigeminal neuralgia treated with gamma knife stereotactic radiosurgery. Neurosurgery 63:915–924
McLaughlin MR, Jannetta PJ, Clyde BL, Subach BR, Comey CH, Resnick DK (1999) Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg 90:1–8
Miyata H, Nitta K, Yamamoto K, Kobayashi T (1993) A case of brachial plexus palsy by the left semi lateral position during general anesthesia. Hokuriku Masuigaku Zassi (Jpn) 27:43–45
Nishihara K, Hanakita J, Kinuta Y, Kondo A, Yamamoto Y, Nakatani H (1986) Importance of intraoperative monitoring of ABR and compound action potential of the eighth cranial nerve during microvascular decompression surgery. No Shinkei Geka 14:509–518
Polo G, Fischer C, Sindou MP, Marneffe V (2004) Brainstem auditory evoked potential monitoring during microvascular decompression for hemifacial spasm: changes and warning values to prevent hearing loss – prospective study in a consecutive series of 84 patients. Neurosurgery 54:97–106
Samii M, Gunther T, Iaconetta G, Muehling M, Vorkapic P, Samii A (2002) Microvascular decompression to treat hemifacial spasm: long-term results for a consecutive series of 143 patients. Neurosurgery 50:712–719
Sekiya T, Moller AR, Jannetta PJ (1986) Pathophysiological mechanisms of intraoperative and postoperative hearing deficits in cerebellopontine angle surgery. Acta Neurochir (Wien) 81:142–151
Conflicts of interest
None
Author information
Authors and Affiliations
Corresponding author
Additional information
Clinical Trial Registration number. None.
Rights and permissions
About this article
Cite this article
Fukunaga, A., Shimizu, K., Yazaki, T. et al. A recommendation on the basis of long-term follow-up resultsof our microvascular decompression operation for hemifacial spasm. Acta Neurochir 155, 1693–1697 (2013). https://doi.org/10.1007/s00701-013-1724-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-013-1724-y