Long-term Outcome of Repeat Microvascular Decompression for Hemifacial Spasm

【作者】 于炎冰； 徐晓利； 张黎；

【Author】 Department of Neurosurgery,China-Japan Friendship Hospital;

【机构】 Department of Neurosurgery,China-Japan Friendship Hospital；

【摘要】 BACKGROUND:Although repeat microvascular decompression(MVD) for hemifacial spasm(HFS) in patients who have failed their prior MVD is potentially curative,little is known about the long-term results of repeat MVD.OBJECTIVE:To evaluate the long-term outcomes and complications after repeat MVD for HFS.METHODS:we performed repeat MVD on 78 consecutive patients who had undergone their prior MVD beyond 1 year.Follow-up data was available for 58 of the 78 patients,and the median follow-up duration was 8.6 years(range 6.9-10.2 years).The patients were assessed for intraoperative findings,relief result and complications at discharge and at follow-up,as well as the associations between the pre-operative characteristics and outcomes.RESULTS:At discharge,of 78 patients with repeat MVD,72(92.3%) patients acquired complete spasm resolution and 1(2.6%) patient had significantly improved spasm resolution.9%(7/78) of patients presented short-term complications including partial hearing loss,hemifacial paresis and cerebrospinal fluid leak.At follow-up,45(77.6%) out of 58 patients had complete relief and 10(17.2%) had improved relief.The permanent complications occurred in 14(24.1%) patients,the commonest being partial hearing loss and mild hemifacial paresis.Despite the complications,51(91.4%) of 58 patients reported an excellent life quality.No significant correlation was found between pre-operative characteristics,such as age,interval to prior MVD or interval to recurrence,and outcomes including short-term or long-term relief results and complications.CONCLUSION:Repeat MVD provides lasting relief for most patients with persistent or recurrent HFS,albeit with a relatively high complication rate.更多还原

【Abstract】 BACKGROUND:Although repeat microvascular decompression(MVD) for hemifacial spasm(HFS) in patients who have failed their prior MVD is potentially curative,little is known about the long-term results of repeat MVD.OBJECTIVE:To evaluate the long-term outcomes and complications after repeat MVD for HFS.METHODS:we performed repeat MVD on 78 consecutive patients who had undergone their prior MVD beyond 1 year.Follow-up data was available for 58 of the 78 patients,and the median follow-up duration was 8.6 years(range 6.9-10.2 years).The patients were assessed for intraoperative findings,relief result and complications at discharge and at follow-up,as well as the associations between the pre-operative characteristics and outcomes.RESULTS:At discharge,of 78 patients with repeat MVD,72(92.3%) patients acquired complete spasm resolution and 1(2.6%) patient had significantly improved spasm resolution.9%(7/78) of patients presented short-term complications including partial hearing loss,hemifacial paresis and cerebrospinal fluid leak.At follow-up,45(77.6%) out of 58 patients had complete relief and 10(17.2%) had improved relief.The permanent complications occurred in 14(24.1%) patients,the commonest being partial hearing loss and mild hemifacial paresis.Despite the complications,51(91.4%) of 58 patients reported an excellent life quality.No significant correlation was found between pre-operative characteristics,such as age,interval to prior MVD or interval to recurrence,and outcomes including short-term or long-term relief results and complications.CONCLUSION:Repeat MVD provides lasting relief for most patients with persistent or recurrent HFS,albeit with a relatively high complication rate.更多还原