title: Management of symptomatic hemifacial spasm or trigeminal neuralgia.
abstract: Hemifacial spasm (HFS) or trigeminal neuralgia (TN) is a kind of hyperactivity disorder of cranial nerves caused by vascular compression. However, sometimes, the disease may arise from nerve damage produced by tumors, which was called as symptomatic HFS/TN. Until now, little is known about the exact mechanism and the necessity of microvascular decompression (MVD) regarding the tumor-induced HFS/TN, which is necessary to be retrospectively analyzed in a considerable sample. Among the 4021 patients who underwent MVD in our department between 2006 and 2014, 44 were finally diagnosed as symptomatic HFS or TN. These patients were focused in this study and their clinical features as well as intraoperative findings and postoperative outcomes were retrospectively investigated. Data analysis exhibited the symptomatic HFS/TN cases accounted for 1.1 % in the study, which were caused by epidermoid in 18 (40.9 %) and meningioma in 15 (34.1 %) followed by neuroma in 7 (15.9 %) as well as aneurysm in 2 (4.5 %) and arteriovenous malformation in 2 (4.5 %). Compared to those with idiopathic HFS/TN, younger females were more susceptible (p < 0.05). After resection of the neoplasm, the offending vessel was identified in 26 (59.1 %), which were followed by MVD process. Postoperatively, the symptoms relief rate was 88.6 %. Our study showed that surgical management of patients with symptomatic HFS/TN may lead to a satisfactory result, yet those primary lesions should be removed firstly. In some cases, a microvascular decompression process might be unnecessary afterward, but the entire nerve root should be checked to exclude any vessel in contact with.
authors.affiliation: Department of Neurosurgery, XinHua Hospital (the Cranial Nerve Disease Center of Shanghai), Shanghai JiaoTong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
authors.forename: Ming-Xing
authors.initials: MX
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, XinHua Hospital (the Cranial Nerve Disease Center of Shanghai), Shanghai JiaoTong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China. ZhongMDPhD@sjtu.edu.cn.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhong
authors.affiliation: Department of Neurosurgery, XinHua Hospital (the Cranial Nerve Disease Center of Shanghai), Shanghai JiaoTong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
authors.forename: Ning-Ning
authors.initials: NN
authors.lastname: Dou
authors.affiliation: Department of Neurosurgery, XinHua Hospital (the Cranial Nerve Disease Center of Shanghai), Shanghai JiaoTong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xia
authors.affiliation: Department of Neurosurgery, XinHua Hospital (the Cranial Nerve Disease Center of Shanghai), Shanghai JiaoTong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, XinHua Hospital (the Cranial Nerve Disease Center of Shanghai), Shanghai JiaoTong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
authors.forename: Shi-Ting
authors.initials: ST
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D003391:Cranial Nerves / Q000473:pathology / Q000601:surgery*; D005260:Female; D019569:Hemifacial Spasm / Q000601:surgery*; D006801:Humans; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery*; D055815:Young Adult
keywords: Cerebellopontine angle; Hemifacial spasm; Microvascular decompression; Symptomatic; Trigeminal neuralgia; Tumors