Microvascular decompression for hemifacial spasm outcome

Microvascular decompression for hemifacial spasm outcome

Microvascular decompression is an effective treatment for hemifacial spasm. Given that postoperative delayed cure was unavoidable, even with accurate identification of the offending vessel and sufficient decompression of the root exit zone, the delayed cure should be considered in patients undergoing reoperation due to lack of remission or relapse after the operation. Additionally, the timing of efficacy assessments should be delayed 1).

The definitive treatment for hemifacial spasm is microvascular decompression (MVD), which cures the disease in 85% to 95% of patients according to reported series. In expert hands, the MVD procedure can be done with relatively low morbidity.

Post-operatively, there may be episodes of mild HFS, however they usually begin to diminish 2–3 days following MVD. Severe spasm that does not abate suggests failure to achieve adequate decompression, and reoperation should be considered.

Surgical results of MVD depends on the duration of symptoms (shorter duration has better prognosis) as well as on the age of the patient (elderly patients do less well). Complete resolution of HFS occurred in 44 (81%) of 54 patients undergoing MVD, however, 6 of these patients had relapse 2). 5 patients (9%) had partial improvement, and 5 (9%) had no relief.


Complete resolution of spasm occurs in ≈ 85–93% 3) 4) 5) 6) 7). Spasm is diminished in 9%, and unchanged in 6% 8). Of 29 patients with complete relief, 25 (86%) had immediate post-op resolution, and the remaining 4 patients took from 3 mos to 3 yrs to attain quiescence.

Recurrence

References

1)

Li MW, Jiang XF, Wu M, He F, Niu C. Clinical Research on Delayed Cure after Microvascular Decompression for Hemifacial Spasm. J Neurol Surg A Cent Eur Neurosurg. 2019 Oct 10. doi: 10.1055/s-0039-1698461. [Epub ahead of print] PubMed PMID: 31600810.
2)

Auger RG, Peipgras DG, Laws ER. Hemifacial Spasm: Results of Microvascular Decompression of the Facial Nerve in 54 Patients. Mayo Clin Proc. 1986; 61:640–644
3)

Rhoton AL. Comment on Payner T D and Tew J M: Recurren ce of Hemifacial Spasm After Microvascular Decompression. Neurosurgery. 1996; 38
4)

Jannetta PJ. Neurovascular Compression in Cranial Nerve and Systemic Disease. Ann Surg. 1980; 192:518–525
5)

Loeser JD, Chen J. Hemifacial Spasm: Treatment by Microsurgical Facial Nerve Decompression. Neurosurgery. 1983; 13:141–146
6)

Huang CI, Chen IH, Lee LS. Microvascular Decompression for Hemifacial Spasm: Analyses of Operative Findings and Results in 310 Patients. Neurosurgery. 1992; 30:53–57
7) , 8)

Payner TD, Tew JM. Recurrence of Hemifacial Spasm After Microvascular Decompression. Neurosurgery. 1996; 38:686–691

XIV National Congress of the Spanish Skull Base Society SEBAC

Official language spanish

see Program here 

We are pleased to address you to present the XIV National Congress of the Spanish Skull Base Society SEBAC, which will be held in Alicante on October 24 and 25, 2019, under the slogan “Multidisciplinary work in Skull Base Surgery”. The pre-congress “Surgical Anatomy of the 3D Skull Base” will be held on Wednesday, October 23, 2019.

It is a great satisfaction for us to invite you to participate in this meeting, oriented to the participation and interaction between professionals, in which we will be able to share new perspectives for the study and debate of the topics of greatest interest and topicality in the field of skull base surgery.

We have accepted the responsibility and commitment to organize this congress, taking care of every detail and motivated to design a scientific program of maximum interest, with national and international guests of maximum recognition, being open to the participation of all interested parties by presenting communications

We have set the goal of holding a congress in which the goal is the learning of skull-based surgeons, with content aimed primarily at the unification of knowledge among different specialists in this field, with the support of numerous contributions and renowned experts and supported by an important audiovisual support that makes the sessions especially educational and intuitive.

From Alicante, the city chosen as the venue for the meeting, we encourage all professionals related to skull base surgery to participate in this experience and to share some pleasant days with us.

Finally, we want to thank the board of our society (SEBAC), the societies of each specialty, SENEC, SEORL, SECOM and also the Formedika Technical Secretariat for their invaluable help and support for the realization of this congress.

A warm greeting.

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