Utility of intraoperative electromyography in microvascular decompression for hemifacial spasm: a meta-analysis.
OBJECTIVE
In this paper, the authors' goal was to determine the utility of monitoring the abnormal muscle response (AMR) or "lateral spread" during microvascular decompression surgery for hemifacial spasm.


METHODS
The authors' experience with AMR as well as the data available in the English-language literature regarding resolution or persistence of AMR and the resolution or persistence of hemifacial spasm at follow-up was pooled and subjected to a meta-analysis.


RESULTS
The pooled OR revealed by the meta-analysis was 4.2 (95% CI 2.7-6.7). The chance of a cure if the AMR was abolished during surgery was 4.2 times greater than if the lateral spread persisted.


CONCLUSIONS
The AMR should be monitored routinely in the operating room, and surgical decision-making in the operating room should be augmented by the AMR.
Center for Cranial Nerve Disorders, Department of Neurosurgery, Allegheny General Hospital, Allegheny Neuroscience Institute/Drexel University College of Medicine, Pittsburgh, Pennsylvania 15212, USA. rsekula@wpahs.org
Raymond F
RF
Sekula
Sanjay
S
Bhatia
Andrew M
AM
Frederickson
Peter J
PJ
Jannetta
Matthew R
MR
Quigley
George A
GA
Small
Ryan
R
Breisinger
D019299:Decompression, Surgical / Q000379:methods*; D004576:Electromyography / Q000379:methods* / Q000706:statistics & numerical data; D005152:Facial Muscles / Q000503:physiopathology*; D005154:Facial Nerve / Q000098:blood supply / Q000503:physiopathology; D005500:Follow-Up Studies; D019569:Hemifacial Spasm / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008866:Microsurgery / Q000379:methods; D055806:Microvessels / Q000601:surgery; D016343:Monitoring, Intraoperative / Q000379:methods* / Q000706:statistics & numerical data