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Reoperation for persistent or recurrent hemifacial spasm after microvascular decompression

 Yong Sook Park  ;  Jong Hee Chang  ;  Joon Cho  ;  Yong Gou Park  ;  Sang Sup Chung  ;  Jin Woo Chang 
 NEUROSURGERY, Vol.58(6) : 1162-1166, 2006 
Journal Title
Issue Date
Adult ; Blood Vessels/pathology ; Chronic Disease ; Decompression, Surgical*/adverse effects ; Facial Nerve/blood supply* ; Female ; Hemifacial Spasm/diagnosis ; Hemifacial Spasm/surgery* ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Angiography ; Male ; Microcirculation* ; Middle Aged ; Recurrence ; Reoperation/adverse effects ; Treatment Outcome ; Vascular Surgical Procedures*/adverse effects
Hemifacial spasm ; Magnetic resonance angiography ; Microvascular decompression ; Recurrence ; Reoperation
OBJECTIVE: The objective of this study was to investigate the outcome of reoperation for persistent or recurrent hemifacial spasm (HFS) after microvascular decompression (MVD).
METHODS: Repeat MVD was performed on 13 patients with an HFS between June 1994 and May 2004. Patients who had compressing offending vessels identified on postoperative (prerevision) three-dimensional short-range magnetic resonance angiography were selected for repeat MVD.
RESULTS: Six patients were found to have no improvement in HFS with the first MVD. All of these patients exhibited excellent improvement after the second MVD. In one patient who had mild improvement with the first MVD, but with more than 50% of remaining spasm, complete abolition of spasm occurred immediately after the second MVD. Six patients showed initial relief and subsequent aggravation of HFS after the first MVD. Of these patients, four had excellent results with the second MVD, one had a good result, and one had a fair outcome. Adverse effects after the second MVD were found in two patients (one patient with permanent mild facial weakness and one patient with hearing impairment). There was no serious morbidity associated with the second MVD.
CONCLUSION: Our data suggest that repeat MVD of the facial nerve may be sufficient to resolve symptoms in selected patients with persistent or recurrent HFS. Additionally, three-dimensional short-range magnetic resonance angiography may help to identify the offending vessels and to select the patients with persistent or recurrent HFS.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Gou(박용구)
Park, Yong Sook(박용숙)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Chung, Sang Sup(정상섭)
Jo, Joon(조준)
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