OBJECTIVE: To explore the effective intracranial surgical method for hemifacial spasm which can be operated more safely and easily. METHOD: Twenty-five cases of hemifacial spasm underwent intracranial facial nerve root combing scraping by improved retrosigmoid approach. The compressing vessels were found in 10 cases and could be removed easily. Both microvascular decompression and facial nerve root combing scraping were performed to reduce recurrence. The other cases with perforating artery or without any compressing vessels underwent the facial nerve root combing scraping and cutting off partially for about 1/6 to approximately 1/5 neural fibers. RESULT: Hemifacial spasms were obliterated in 22 cases (88%) after operation, obviously relieved in 2 cases (8%), invalid in 1 case (4%). Varied facial nerve paralysis was observed in 25 patients, but no hearing disturbance and other serious complication occurred. Follow-up for 2 to approximately 8 years showed there were recurrences in 2 cases (8%) and the facial nerve paralysis of 25 cases recovered in 1 to approximately 6 months after operation. CONCLUSION: The facial nerve root combing scraping is an effective and safe microsurgical procedure which has wide-ranged indication and less complication. It is very important to select suitable treatment for the patient individually during the operation to improve the efficacy and lower the risk.
OBJECTIVE: To explore the effective intracranial surgical method for hemifacial spasm which can be operated more safely and easily. METHOD: Twenty-five cases of hemifacial spasm underwent intracranial facial nerve root combing scraping by improved retrosigmoid approach. The compressing vessels were found in 10 cases and could be removed easily. Both microvascular decompression and facial nerve root combing scraping were performed to reduce recurrence. The other cases with perforating artery or without any compressing vessels underwent the facial nerve root combing scraping and cutting off partially for about 1/6 to approximately 1/5 neural fibers. RESULT: Hemifacial spasms were obliterated in 22 cases (88%) after operation, obviously relieved in 2 cases (8%), invalid in 1 case (4%). Varied facial nerve paralysis was observed in 25 patients, but no hearing disturbance and other serious complication occurred. Follow-up for 2 to approximately 8 years showed there were recurrences in 2 cases (8%) and the facial nerve paralysis of 25 cases recovered in 1 to approximately 6 months after operation. CONCLUSION: The facial nerve root combing scraping is an effective and safe microsurgical procedure which has wide-ranged indication and less complication. It is very important to select suitable treatment for the patient individually during the operation to improve the efficacy and lower the risk.
Authors: Concetta Alafaci; Francesca Granata; Mariano Cutugno; Giovanni Grasso; Francesco M Salpietro; Francesco Tomasello Journal: Surg Neurol Int Date: 2014-07-16