The Efficacy of Microvascular Decompression for Hemifacial Spasm

Kang, Dong Wan; Cho, Won Ho; Choi, Chang Hwa

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2006;2(1):55-62.
Published online June 30, 2006.

The Efficacy of Microvascular Decompression for Hemifacial Spasm

Dong Wan Kang, Won Ho Cho, Chang Hwa Choi

Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Korea

Abstract

Objective
It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone of the facial nerve. Microvascular decompression (MVD) is an effective modality for the hemifacial spasm. We report the surgical techniques and outcomes of MVD in hemifacial spasm with the literature review.
Methods
From January 1996 to June 2004, 50 patients with hemifacial spasm underwent MVD. The effect of MVD was analyzed according to the degree of neural compression by vessels identified in operative field. Reoperation cases also analyzed according to the causes of failure and final outcome.
Results
The common offending vessels were anterior inferior cerebellar artery and posterior inferior cerebellar artery. In seven cases whose spasm was unrelieved after the first operation, early reoperation was performed and became free of spasm in all cases. The overall excellent and good result of this study was 88%.
Conclusion
MVD for hemifacial spasm is a safe and reliable treatment with good results. The overall outcome and final results of reoperations were excellent in this study. Especially, when the spasm was not improved within 2 weeks after first operation, we recommend early reoperation because the reason of failure might be compression by another vessel or incomplete decompression of the offending vessels and delayed reoperation also might be more difficult due to severe adhesion of vessels or nerves with prosthesis.

Key Words: Hemifacial spasm, Microvascular decompression, Reoperation, Outcome.