Outcome of microvascular decompression for hemifacial spasm associated with the vertebral artery.
We retrospectively compared the outcome of microvascular decompression (MVD) for hemifacial spasm (HFS) associated with the vertebral artery (VA) with that of MVD for HFS unrelated to the VA. Between April 2008 and April 2015, 22 patients with VA-associated HFS underwent MVD at our institution. The median follow-up period was 28 months (range, 12-90 months). Results were classified as excellent in 19 patients (86 %), good in one (5 %), fair in one (5 %), and poor in one (5 %). Immediate complications developed in five patients (23 %), and one of these complications (5 %) was permanent. The surgical outcome of MVD for VA-associated HFS was similar to that of MVD for HFS unrelated to the VA; however, the incidence of complications was significantly more frequent in patients whose VA compressed the more proximal portion of the facial nerve root exit zone from the caudal side at the pontomedullary sulcus. We conclude that preoperative evaluation of VA compression patterns is important to predict the difficulty of the planned MVD procedure.
Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, 849-8501, Japan. masuoka@cc.saga-u.ac.jp.
Jun
J
Masuoka
Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Toshio
T
Matsushima
Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Yukiko
Y
Nakahara
Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Kouhei
K
Inoue
Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Fumitaka
F
Yoshioka
Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Masatou
M
Kawashima
Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Tatsuya
T
Abe
D000328:Adult; D000368:Aged; D005154:Facial Nerve / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D019569:Hemifacial Spasm / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D061145:Microvascular Decompression Surgery; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D055815:Young Adult
Complication; Hemifacial spasm; Microvascular decompression; Vertebral artery