Microvascular decompression for hemifacial spasm: analyses of operative complications in 1582 consecutive patients.
BACKGROUND
Microvascular decompression is the most reliable treatment for HFS, but it may cause complications. The aim was to identify factors affecting the prognosis after MVD and to establish appropriate means to reduce complications.


METHODS
We retrospectively reviewed 1524 patients with HFS who underwent MVD and were followed for more than 6 months since January 1987. The mean follow-up duration was 30.9 months (6-197 months).


RESULTS
The effect of MVD was satisfying (excellent or good) in 94.6% (n = 1442). The failure and recurrence rates were 2.1% (n = 32) and 0.4% (n = 6), respectively. Postoperative complications were noted in 545 (35.8%) patients. Among them, facial palsy, hearing deficit, and low cranial nerve palsies were found in 18.6% (n = 283), 7.2% (n = 109), and 2.8% (n = 43), respectively. However, permanent facial weakness, hearing deficit, and lower cranial nerve palsies such as hoarseness and dysphagia were encountered in 1.2% (n = 18), 2.1% (n = 32), and 0.1% (n = 2), respectively. The more immediate and severe the facial palsy was, the more permanent it remained, with statistical significance (P < .05). There was a trend that the more immediate and severe the hearing deficit was, the more permanent the deficit remained, without statistical significance (P = .673).


CONCLUSIONS
Early (occurrence within 24 hours after operation) and severe cranial nerve deficits, including facial, hearing, and lower cranial nerve deficits after MVD, entail the risk to stay permanent.
Huh
Ryoong
R
Department of Neurosurgery, College of Medicine, Pochun CHA University, Bundang-gu, Sungnam 463-712, South Korea.
Han
In Bo
IB
Moon
Ji Young
JY
Chang
Jin Woo
JW
Chung
Sang Sup
SS
D000293:Adolescent; D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects*; D005155:Facial Nerve Diseases / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000209:etiology; D019569:Hemifacial Spasm / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome