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Microvascular decompression for hemifacial spasm: analyses of operative complications in 1582 consecutive patients.

Authors
 Ryoong Huh  ;  In Bo Han  ;  Ji Young Moon  ;  Jin Woo Chang  ;  Sang Sup Chung 
Citation
 SURGICAL NEUROLOGY , Vol.69(2) : 153-157, 2008 
Journal Title
SURGICAL NEUROLOGY
ISSN
 0090-3019 
Issue Date
2008
MeSH
Adolescent ; Adult ; Aged ; Decompression, Surgical/adverse effects* ; Facial Nerve Diseases/etiology* ; Female ; Follow-Up Studies ; Hearing Loss/etiology ; Hemifacial Spasm/etiology ; Hemifacial Spasm/surgery* ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome
Keywords
Facial palsy ; Hearing deficit ; Hemifacial spasm ; Microvascular decompression
Abstract
BACKGROUND: Microvascular decompression is the most reliable treatment for HFS, but it may cause complications. The aim was to identify factors affecting the prognosis after MVD and to establish appropriate means to reduce complications.

METHOD: We retrospectively reviewed 1524 patients with HFS who underwent MVD and were followed for more than 6 months since January 1987. The mean follow-up duration was 30.9 months (6-197 months).

RESULTS: The effect of MVD was satisfying (excellent or good) in 94.6% (n = 1442). The failure and recurrence rates were 2.1% (n = 32) and 0.4% (n = 6), respectively. Postoperative complications were noted in 545 (35.8%) patients. Among them, facial palsy, hearing deficit, and low cranial nerve palsies were found in 18.6% (n = 283), 7.2% (n = 109), and 2.8% (n = 43), respectively. However, permanent facial weakness, hearing deficit, and lower cranial nerve palsies such as hoarseness and dysphagia were encountered in 1.2% (n = 18), 2.1% (n = 32), and 0.1% (n = 2), respectively. The more immediate and severe the facial palsy was, the more permanent it remained, with statistical significance (P < .05). There was a trend that the more immediate and severe the hearing deficit was, the more permanent the deficit remained, without statistical significance (P = .673).

CONCLUSION: Early (occurrence within 24 hours after operation) and severe cranial nerve deficits, including facial, hearing, and lower cranial nerve deficits after MVD, entail the risk to stay permanent.
Full Text
http://www.sciencedirect.com/science/article/pii/S0090301907008233
DOI
10.1016/j.surneu.2007.07.027
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108309
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