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Erschienen in:
01.12.2010 | Clinical Article
An analysis of failed microvascular decompression in patients with hemifacial spasm: focused on the early reoperative findings
Erschienen in: Acta Neurochirurgica | Ausgabe 12/2010
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Background
Although the microvascular decompression (MVD) has become a definitive treatment for the primary hemifacial spasm (HFS), there still are some failed cases. To obtain a satisfactory postoperative outcome, those failure cases of MVD need to be analyzed.
Method
Between January and October 2009, 393 patients with primary HFS underwent MVD. Postoperatively, 375 presented complete spasm-free, 7 improved apparently, and 11 without any improvement at all. A reoperation was performed in 9 of the 11 patients who had poor outcome within 5 days. Those redo MVD cases were reviewed.
Findings
After the reoperation, the symptom of those patients all disappeared immediately. Therefore, the final outcomes were excellent in 97.7%, good in 1.8%, and poor in 0.5%. Up to the 1 year follow-up period, neither recurrence nor change was found. For the two patients without reoperation, their symptoms remained. The previous surgery was a failure due to insufficient decompression in two and conflict missed in seven.
Conclusions
A successful MVD operation is attributable to a thorough exploration of the entire nerve course. An early relief should become the ambition of the operator while performing MVD.