Postoperative complications of microvascular decompression for hemifacial spasm: lessons from experience of 2040 cases

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• 作者：Min Ho Lee ; Tae Keun Jee ; Jeong Ah Lee ; Kwan Park
• 关键词：Microvascular decompression ; Hemifacial spasm ; Complication ; Hearing loss ; Facial palsy
• 刊名：Neurosurgical Review
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：39
• 期：1
• 页码：151-158
• 全文大小：352 KB
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• 作者单位：Min Ho Lee (1)
  Tae Keun Jee (1)
  Jeong Ah Lee (1)
  Kwan Park (1)
  
  1. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Neurosurgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1437-2320

文摘

Microvascular decompression (MVD) is an effective and safe treatment option that offers the prospect of definitive cure for hemifacial spasm (HFS). However, there are potential risks of complications for MVD associated with retromastoid suboccipital craniectomy (RmSOC) and cranial nerves in particular. The purpose of this study was to identify clinical characteristics of possible complications after MVD for HFS and to establish appropriate management concept of these complications. We retrospectively reviewed medical records of 2040 patients who underwent RmSOC with MVD for HFS at Samsung medical center between January 1998 and March 2013. Of 2040 patients, 2027 were followed (99.4 %). Of the 2027 patients, 1841 (90.8 %) exhibited complete relief or minimal symptoms, and 113 (5.6 %) reported improved spasm but had mild remnant symptoms. After operation, the most frequently developed complications were facial nerve palsy (8.19 %), followed by middle ear effusion (4.90 %) and hearing loss (3.63 %). There were two cases of supratentorial subdural hemorrhage, three cases of infarction. MVD was found to be safe and effective treatment for HFS, in consistent with previous reports. Some of the complications such as facial nerve palsy, middle ear effusion, and hearing loss are relatively common. However, they have mild clinical courses that are usually transient. Keywords Microvascular decompression Hemifacial spasm Complication Hearing loss Facial palsy