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Delayed recurrence of hemifacial spasm after successful microvascular decompression: follow-up results at least 5 years after surgery

 Chang, Won Seok  ;  Chung, Jong Chul  ;  Kim, Joo Pyung  ;  Chung, Sang Sup  ;  Chang, Jin Woo 
 ACTA NEUROCHIRURGICA, Vol.154(9) : 1613-1619, 2012 
Journal Title
Issue Date
Adult ; Aged ; Cerebellum/blood supply ; Female ; Follow-Up Studies ; Hemifacial Spasm/diagnosis* ; Hemifacial Spasm/surgery* ; Humans ; Kaplan-Meier Estimate ; Male ; Microvascular Decompression Surgery* ; Middle Aged ; Neurologic Examination ; Postoperative Complications/diagnosis* ; Postoperative Complications/surgery* ; Probability ; Recurrence ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Vertebral Artery/surgery ; Young Adult
Hemifacial spasm ; Microvascular decompression ; Predisposing factor ; Recurrence
BACKGROUND: Microvascular decompression (MVD) for hemifacial spasm (HFS) is regarded as the gold-standard treatment due to its efficacy and durability. However, some patients still suffer from delayed recurrence after initially successful MVD.In this study, we describe our clinical experience in a single institute following up initially successful MVD for HFS 5 or more years after surgery. We analyzed the probability of, risk/predisposing factors for, and timing of delayed recurrence. METHODS: We retrospectively reviewed data from 587 patients meeting our inclusion criteria who underwent MVD for HFS from March, 1999, to June, 2006. We evaluated the time-dependent probability of recurrence and factors affecting delayed recurrence and time of recurrence. RESULTS: The probability of delayed recurrence was 1.0, 1.7, and 2.9 % at 1 year, 2 years, and 5 years after surgery, respectively. Mean time to recurrence was 153.1 months (95 % confidence interval [151.4-154.9]). The probability of late recurrence was increased in patients with co-morbid arterial hypertension (p = 0.036). However, there was a trend towards an association of delayed recurrence with co-existence of young age, male gender, vein or VA offender, and experience of transient facial weakness. CONCLUSIONS: Delayed recurrence of HFS after initially successful MVD is rare; however, there are patients who experience delayed recurrence more than 2 years after MVD, even until 5 years after MVD. Our results suggest that arterial hypertension contributes to late recurrence. We did not find a statistically significant relationship between recurrence and other putative risk/predisposing factors.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Joo Pyung(김주평)
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Chung, Jong Chul(정종철)
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