Microvascular decompression of the facial nerve for hemifacial spasm in youth.
OBJECTIVE
The goal of this study was to investigate the differences between clinical findings in youth and in adulthood on microvascular decompression (MVD) of the facial nerve for the treatment of hemifacial spasm (HFS).


METHODS
We retrospectively evaluated 855 patients who underwent MVD from January 1985 to July 1999. In our series of 33 young HFS patients, all patients had definite offending vessels. Interestingly, pathologic tortuous vertebral artery as a possible etiology was more rarely observed in young HFS patients (1/33 patients, 3.0%) than in adult patients (61/822 patients, 7.4%) (P < 0.05). We did not observe any atomical variations of the vessels or any arachnoidal thickening around the root entry zone and cerebellopontine cistern in youths. Furthermore, young HFS patients did not necessarily have poorer surgical outcomes than adult HFS patients.


CONCLUSIONS
Our results suggest that the cause and progress of HFS are the same in youth as in adulthood, even though the pathogenesis of early onset remains unclear.
Chang
J W
JW
Department of Neurosurgery and Brain Research Institute, Yonsei University College of Medicine, CPO Box 8044, Seoul, Korea.
Chang
J H
JH
Park
Y G
YG
Chung
S S
SS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001158:Arteries / Q000601:surgery; D002531:Cerebellum / Q000098:blood supply; D002648:Child; D019299:Decompression, Surgical; D005155:Facial Nerve Diseases / Q000209:etiology / Q000601:surgery*; D005260:Female; D019569:Hemifacial Spasm / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000601:surgery; D008866:Microsurgery; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000601:surgery