Risk Factors of Repeated Microvascular Decompression for Hemifacial Spasm

Cho, Hyun; Ko, Yong; Yi, Hyeong-Joong

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2007;3(1):44-47.
Published online June 30, 2007.

Risk Factors of Repeated Microvascular Decompression for Hemifacial Spasm

Hyun Cho, Yong Ko, Hyeong-Joong Yi

Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea

Abstract

Objective
The goal of this study is to investigate risk factors for reoperation due to persistent hemifacial spasm or recurrence, in addition to the complications after microvascular decompression. Materials and Method: During the last 10 years, 60 procedures of microvascular decompression were performed in patients with hemifacial spasm. Retrospective analysis was conducted in 60 patients with special reference to the reoperation and relevant clinical factors.
Results
Six patients underwent reoperation due to persistent hemifacial spasm or complication, symptom was improved in 5 patients except 1 patient with anatomical complexity. Preoperative factors including sex, direction, duration of symtom had no significant relation with reoperation. But, in case of ectatic vessel as a offending vascular structure, reoperation is more frequent (p=0.043). Overall complication rate was 11%.
Conclusion
When an offending vascular structure was ectatic variant, reoperation was more frequent. In such instance, careful preoperative radiologic interpretation and alternative surgical option is mandated.

Key Words: Hemifacial spasm, Microvacular decompression, Reoperation.