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Outcome of microvascular decompression for hemifacial spasm associated with the vertebral artery

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Abstract

We retrospectively compared the outcome of microvascular decompression (MVD) for hemifacial spasm (HFS) associated with the vertebral artery (VA) with that of MVD for HFS unrelated to the VA. Between April 2008 and April 2015, 22 patients with VA-associated HFS underwent MVD at our institution. The median follow-up period was 28 months (range, 12–90 months). Results were classified as excellent in 19 patients (86 %), good in one (5 %), fair in one (5 %), and poor in one (5 %). Immediate complications developed in five patients (23 %), and one of these complications (5 %) was permanent. The surgical outcome of MVD for VA-associated HFS was similar to that of MVD for HFS unrelated to the VA; however, the incidence of complications was significantly more frequent in patients whose VA compressed the more proximal portion of the facial nerve root exit zone from the caudal side at the pontomedullary sulcus. We conclude that preoperative evaluation of VA compression patterns is important to predict the difficulty of the planned MVD procedure.

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References

  1. 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 (Wien) 154:501–508. doi:10.1007/s00701-011-1247-3

    Article  Google Scholar 

  2. 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

    Article  CAS  PubMed  Google Scholar 

  3. Hitotsumatsu T, Matsushima T, Inoue T (2003) Micovascular decompression for treatment of trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia: three surgical approach variations. Neurosurgery 53:1436–1443

    Article  PubMed  Google Scholar 

  4. Masuoka J, Matsushima T, Kawashima M, Nakahara Y, Funaki T, Mineta T (2011) Stitched sling retraction technique for microvascular decompression: procedures and techniques based on an anatomical viewpoint. Neurosurg Rev 34:373–380. doi:10.1007/s10143-011-0310-0

    Article  PubMed  Google Scholar 

  5. Matsushima T (2015) Microsurgical anatomy and surgery of the posterior cranial fossa. Springer, pp 151–162

  6. Kondo A, Date I, Endo S, Fujii K, Fujimaki T, Hasegawa M, Hatayama T, Hongo K, Inoue T, Ishikawa M, Ito M, Kayama T, Kohmura E, Matsushima T, Munemoto S, Nagahiro S, Ohno K, Okumura T, Ryu H, Shigeno T, Shirane R, Tagusagawa Y, Tanabe H, Yamada K, Yamakami I (2012) A proposal for standardized analysis of the results of microvascular decompression for trigeminal neuralgia and hemifacial spasm. Acta Neurochir (Wien) 154:773–778. doi:10.1007/s00701-012-1277-5

    Article  Google Scholar 

  7. Barker FG 2nd, Jannetta PJ, Bissonette DJ, Shields PT, Larkins MV, Jho HD (1995) Microvascular decompression for hemifacial spasm. J Neurosurg 82:201–210

    Article  PubMed  Google Scholar 

  8. Hyun SJ, Kong DS, Park K (2010) Microvascular decompression for treating hemifacial spasm: lessons learned from a prospective study of 1,174 operations. Neurosurg Rev 33:325–334. doi:10.1007/s10143-010-0254-9

    Article  PubMed  Google Scholar 

  9. Samii M, Gunther T, Iaconetta G, Muehling M, Vorkapic P, Samii A (2002) Microvascular decompression to treat hemifacial spasm: long-term results for consecutive series of 143 patients. Neurosurgery 50:712–718

    Article  PubMed  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 36:303–309. doi:10.1007/s10143-012-0425-y

    Article  PubMed  Google Scholar 

  11. Hong JM, Chung CS, Bang OY, Yong SW, Joo IS, Huh K (2009) Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts. J Neurol Neurosurg Psychiatry 80:1087–1092. doi:10.1136/jnnp.2008.169850

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Park JS, Koh EJ, Choi HY, Lee JM (2015) Characteristic anatomical conformation of the vertebral artery causing vascular compression against the root exit zone of the facial nerve in patients with hemifacial spasm. Acta Neurochir (Wien) 157:449–454. doi:10.1007/s00701-014-2338-8

    Article  Google Scholar 

  13. Campos-Benitez M, Kaufmann AM (2008) Neurovascular compression findings in hemifacial spasm. J Neurosurg 109:416–420

    Article  PubMed  Google Scholar 

  14. Liang Q, Shi X, Wang Y, Sun Y, Wang R, Li S (2012) Microvasculae decompression for hemifacial spasm: technical notes on pontomedullary sulcus decompression. Acta Neurochir (Wien) 154:1621–1626. doi:10.1007/s00701-012-1387-0

    Article  Google Scholar 

  15. Attabib N, Kaufmann A (2007) Use of fenestrated aneurysm clips in microvascular decompression surgery. J Neurosurg 106:929–931

    Article  PubMed  Google Scholar 

  16. Ferreira M, Walcott BP, Nahed BV, Sekhar LN (2011) Vertebral artery pexy for microvascular decompression of the facial nerve in the treatment of hemifacial spasm. J Neurosurg 114:1800–1804

    Article  PubMed  Google Scholar 

  17. Kyoshima K, Watanabe A, Toba Y, Nitta J, Muraoka S, Kobayashi S (1999) Anchoring method for hemifacial spasm associated with vertebral artery: technical note. Neurosurgery 45:1487–1491

    Article  CAS  PubMed  Google Scholar 

  18. Lin CF, Chen HH, Hernesniemi J, Lee CC, Liao CH, Chen SC, Chen MH, Shih YH, Hsu SP (2012) An easy adjustable method of ectatic vertebrobasilar artery transposition for microvascular decompression. Clin Neurol Neurosurg 114:951–956. doi:10.1016/j.clineuro.2012.02.012

    Article  PubMed  Google Scholar 

  19. Tanaka Y, Uchida M, Onodera H, Hiramoto J, Yoshida Y (2014) Simple transposition technique for microvascular decompression using an expanded polytetrafluoroethylene “belt”: technical note. Neurol Med Chir (Tokyo) 54:483–485

    Article  Google Scholar 

  20. Zaidi HA, Awad AW, Chowdhry SA, Fusco D, Nakaji P, Spetzler RF (2015) Microvascular decompression for hemifacial spasm secondary to vertebrobasilar dolichoectasia: surgical strategies, technical nuances and clinical outcomes. J Clin Neurosci 22:62–68

    Article  PubMed  Google Scholar 

  21. Fukuda M, Oishi M, Hiraishi T, Saito A, Fujii K (2012) Pharyngeal motor evoked potentials elicited by transcranial electrical stimulation for intraoperative monitoring during skull base surgery. J Neurosurg 116:605–610

    Article  PubMed  Google Scholar 

  22. Ito E, Ichikawa M, Itakura T, Ando H, Matsumoto Y, Oda K, Sato T, Watanabe T, Sakuma J, Saito K (2013) Motor evoked potential monitoring of the vagus nerve with transcranial electrical stimulation during skull base surgeries. J Neurosurg 118:195–201

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, 849-8501, Japan

    Jun Masuoka, Toshio Matsushima, Yukiko Nakahara, Kouhei Inoue, Fumitaka Yoshioka, Masatou Kawashima & Tatsuya Abe

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  1. Jun Masuoka
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  2. Toshio Matsushima
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  3. Yukiko Nakahara
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  4. Kouhei Inoue
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  5. Fumitaka Yoshioka
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  6. Masatou Kawashima
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  7. Tatsuya Abe
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Correspondence to Jun Masuoka.

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

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  • DOI: https://doi.org/10.1007/s10143-016-0759-y

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