Hua Zhao1, Xin Zhang1, Yin-da Tang1, Ying Zhang2, Ting-Ting Ying1, Jin Zhu3, Shi-Ting Li4. 1. Department of Neurosurgery, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Department of Orthopedics, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 3. Department of Neurosurgery, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: medzhujin@126.com. 4. Department of Neurosurgery, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: xinhuaneuro@126.com.
Abstract
BACKGROUND: Although microvascular decompression (MVD) surgery is considered the gold standard treatment for hemifacial spasm, there are some MVD-related complications. METHODS: We retrospectively reviewed 1548 patients with hemifacial spasm who underwent retromastoid suboccipital craniectomy with MVD from January 2009 to June 2013. All patients were followed for >2 years. RESULTS: Excellent and good results were 92.5% and 4.2%, respectively. Postoperative complications were recorded in 16.09% (n = 249). There was no MVD-related mortality. After MVD surgery, the most frequent complications were occipital sensory disturbance (7.3%), facial nerve palsy (9.7%), and hearing impairment (3.5%). Other complications were as follows: cerebrospinal fluid leakage (n = 24), poor healing wound (n = 14), lower cranial nerve palsy (n = 12), wound infection (n = 4), and hemorrhage (n = 2). CONCLUSIONS: MVD operation is a safe treatment for hemifacial spasm. Facial nerve palsy is the most common MVD-related complication; preservation of the lesser occipital nerve during MVD surgery can decrease the rate of occipital sensory disturbance. Permanent or serious complications are comparatively rare in MVD surgery.
BACKGROUND: Although microvascular decompression (MVD) surgery is considered the gold standard treatment for hemifacial spasm, there are some MVD-related complications. METHODS: We retrospectively reviewed 1548 patients with hemifacial spasm who underwent retromastoid suboccipital craniectomy with MVD from January 2009 to June 2013. All patients were followed for >2 years. RESULTS: Excellent and good results were 92.5% and 4.2%, respectively. Postoperative complications were recorded in 16.09% (n = 249). There was no MVD-related mortality. After MVD surgery, the most frequent complications were occipital sensory disturbance (7.3%), facial nerve palsy (9.7%), and hearing impairment (3.5%). Other complications were as follows: cerebrospinal fluid leakage (n = 24), poor healing wound (n = 14), lower cranial nerve palsy (n = 12), wound infection (n = 4), and hemorrhage (n = 2). CONCLUSIONS: MVD operation is a safe treatment for hemifacial spasm. Facial nerve palsy is the most common MVD-related complication; preservation of the lesser occipital nerve during MVD surgery can decrease the rate of occipital sensory disturbance. Permanent or serious complications are comparatively rare in MVD surgery.
Authors: Katherine Holste; Ronald Sahyouni; Zoe Teton; Alvin Y Chan; Dario J Englot; John D Rolston Journal: World Neurosurg Date: 2020-04-16 Impact factor: 2.104
Authors: Birgit Coucke; Laura Van Gerven; Steven De Vleeschouwer; Frank Van Calenbergh; Johannes van Loon; Tom Theys Journal: Neurosurg Rev Date: 2021-09-09 Impact factor: 3.042
Authors: Daniel I Wolfson; Jordan A Magarik; Saniya S Godil; Hamid M Shah; Joseph S Neimat; Peter E Konrad; Dario J Englot Journal: J Neurol Surg B Skull Base Date: 2020-08-20