title: Prognostic value of intra-operative abnormal muscle response monitoring during microvascular decompression for long-term outcome of hemifacial spasm.
abstract: The reliability of intra-operative abnormal muscle response (AMR) monitoring as an indicator of post-operative outcome in patients with hemifacial spasm (HFS) is under debate. The primary aim of this study was to evaluate the correlation between intra-operative AMR changes and long-term post-operative outcome. We monitored intra-operative AMR during microvascular decompression (MVD) in consecutive patients with HFS (n = 104). Patients in this study were divided into two groups based on whether their AMR disappeared or persisted following MVD. Ninety patients were followed-up, and the mean duration from surgery to final follow-up examination was 3.7 years. Fourteen patients were lost to follow-up. AMR disappeared during surgery for 80 patients; of these, 74 achieved complete resolution of HFS, five had persistent HFS, and one patient developed a recurrence of HFS. Of the 10 patients with persistent AMR despite effective MVD, eight patients achieved complete resolution, one patient had persistent HFS, and one developed recurrent HFS. The long-term clinical outcome of HFS after MVD did not significantly correlate with intra-operative AMR changes (p = 0.791). Therefore, we suggest that intra-operative AMR monitoring may not be a reliable indicator of long-term post-operative outcome for HFS.
authors.affiliation: Department of Functional Neurosurgery of Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Jiping
authors.initials: J
authors.lastname: Li
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhu
authors.forename: Yongjie
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D005152:Facial Muscles / Q000294:innervation / Q000503:physiopathology*; D005155:Facial Nerve Diseases / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D019569:Hemifacial Spasm / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011379:Prognosis; D012021:Reflex, Abnormal / Q000502:physiology*; D013995:Time; D016896:Treatment Outcome; D055815:Young Adult