title: A recommendation on the basis of long-term follow-up results of our microvascular decompression operation for hemifacial spasm.
abstract: BACKGROUND
  Microvascular decompression (MVD) for hemifacial spasm (HFS) has been popular, but it may take enough time to master this special operative technique and procedure. This may induce uneven distribution of the number of MVD operations in each institute, possibly resulting in an overall unsatisfactory quality of MVD surgeons. Nakanishi's approach to MVD operations has the feature of using a, "supine, no retractor" technique, which would achieve various benefits for patients and medical professionals. We would like to recommend this approach for MVD surgeons on the basis of our follow-up outcomes.
  
  
  METHODS
  A questionnaire, which was based on the method of evaluation for the long-term results of post-MVD operation as recommended by the Japanese Society of MVD, was sent by mail to the 154 HFS patients who had received Nakanishi's approach at our hospital.
  
  
  RESULTS
  Except for 42 patients who had changed their residences, 89 patients (79.5 % of 112) fully answered. The mean postoperative follow-up term was 13.0 years. The 76.4 % of the patients was estimated as excellent. Postoperative deafness was not present. The average value of satisfaction degree for the results of the MVD operation was 87.9 %.
  
  
  CONCLUSIONS
  This study revealed that Nakanishi's approach produced good results equivalent of other approaches for HFS patients. This approach is considered to have many advantages comparing to the other approaches. Therefore, we would like to recommend that Nakanishi's approach would contribute to overall advancement of the level of MVD surgeons.
authors.affiliation: Department of Neurosurgery, Kyosai Tachikawa Hospital, 4-2-22 Nishiki-cho, Tachikawa City, Tokyo, 190-8531, Japan. atsushi3@za.bb-east.ne.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fukunaga
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Shimizu
authors.forename: Takahito
authors.initials: T
authors.lastname: Yazaki
authors.forename: Masato
authors.initials: M
authors.lastname: Ochiai
mesh_terms: D000328:Adult; D000368:Aged; D005152:Facial Muscles / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D019569:Hemifacial Spasm / Q000601:surgery*; D006801:Humans; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome