Clinical analysis of microvascular decompression in patients with hemifacial spasm: a retrospective study.

BACKGROUND

Unilateral contractions of the facial muscles characterize hemifacial spasm (HFS). Microvascular decompression (MVD) was widely accepted for the treatment of HFS. To investigate the operative effects and surgical complications in patients with HFS after MVD.

METHODS

A retrospective analysis of 540 patients with HFS after MVD was conducted from January 2017 to May 2018. All patients were followed up for 2 years on average. Surgical effects were evaluated on the patients' manifestations according to the Cohen score classification.

RESULTS

During the follow-up period, 455 patients (84.26%) were completely cured, 60 patients (11.11%) were partial relief, 25 patients (4.63%) were failed cure. The effective rate was 93.52% on the first day after MVD, and 95.37% on the follow-up period. Ten patients (1.85%) were facial paralysis (FP) on the 1st day of post-operation. Twenty-five patients (4.63%), FP; the patients with delayed facial palsy were all completely cured in 3 months. Fourteen patients (2.59%) were hearing deficit after MVD, in whom 8 patients (1.48%) had good improvement, and 6 patients (1.11%) had no changes. There was no recurrence case or death case recorded.

CONCLUSIONS

MVD is the best treatment choice that offers the prospect of a definitive cure for HFS. Skilled microsurgical techniques, as well as identifying and sufficiently decompressing offending vessels, are the key to ensuring a safe and successful MVD. Complications of this surgery are uncommon and transient.