Indications and Timings of Re-operation for Residual or Recurrent Hemifacial Spasm after Microvascular Decompression : Personal Experience and Literature Review
We reviewed reports about the postoperative course of hemifacial spasm (HFS) after microvascular decompression (MVD), including in our own patients, and investigated treatment for delayed resolution or recurrence of HFS. Symptoms of HFS disappear after surgery in many patients, but spasm persists postoperatively in about 10-40%. Residual spasm also gradually decreases, with rates of 1-13% at 1 year postoperatively. However, because delayed resolution is uncommon after 1 year postoperatively, the following is advised: (1) In patients with residual spasms after 1 year postoperatively (incomplete cure) or who again experience spasm ≥ 1 year postoperatively (recurrence), re-operation is recommended if the spasms are worse than before MVD. (2) When re-operation is considered, preoperative magnetic resonance imaging (MRI) findings and intraoperative videos should be reviewed to ensure that no compression due to a small artery or vein was missed, and to confirm that adhesions with the prosthesis are not causing compression. If any suspicious findings are identified, the cause must be eliminated. Moreover, because of the risk of nerve injury, decompression of the distal portion of the facial nerve should be performed only in patients in whom distal compression is strongly suspected to be the cause of symptoms. (3) Cure rates after re-operation are high, but complications such as hearing impairment and facial weakness have been reported in 10-20% of cases, so surgery must be performed with great care.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2015 |
|---|---|
| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:55 |
|---|---|
| Enthalten in: |
Neurologia medico-chirurgica - 55(2015), 8 vom: 30., Seite 663-8 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Hatayama, Toru [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 24.04.2017 Date Revised 21.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.2176/nmc.ra.2014-0386 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM251384799 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM251384799 | ||
| 003 | DE-627 | ||
| 005 | 20240321234656.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231224s2015 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.2176/nmc.ra.2014-0386 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1338.xml |
| 035 | |a (DE-627)NLM251384799 | ||
| 035 | |a (NLM)26226977 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Hatayama, Toru |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Indications and Timings of Re-operation for Residual or Recurrent Hemifacial Spasm after Microvascular Decompression |b Personal Experience and Literature Review |
| 264 | 1 | |c 2015 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 24.04.2017 | ||
| 500 | |a Date Revised 21.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a We reviewed reports about the postoperative course of hemifacial spasm (HFS) after microvascular decompression (MVD), including in our own patients, and investigated treatment for delayed resolution or recurrence of HFS. Symptoms of HFS disappear after surgery in many patients, but spasm persists postoperatively in about 10-40%. Residual spasm also gradually decreases, with rates of 1-13% at 1 year postoperatively. However, because delayed resolution is uncommon after 1 year postoperatively, the following is advised: (1) In patients with residual spasms after 1 year postoperatively (incomplete cure) or who again experience spasm ≥ 1 year postoperatively (recurrence), re-operation is recommended if the spasms are worse than before MVD. (2) When re-operation is considered, preoperative magnetic resonance imaging (MRI) findings and intraoperative videos should be reviewed to ensure that no compression due to a small artery or vein was missed, and to confirm that adhesions with the prosthesis are not causing compression. If any suspicious findings are identified, the cause must be eliminated. Moreover, because of the risk of nerve injury, decompression of the distal portion of the facial nerve should be performed only in patients in whom distal compression is strongly suspected to be the cause of symptoms. (3) Cure rates after re-operation are high, but complications such as hearing impairment and facial weakness have been reported in 10-20% of cases, so surgery must be performed with great care | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 700 | 1 | |a Kono, Takuji |e verfasserin |4 aut | |
| 700 | 1 | |a Harada, Yoichi |e verfasserin |4 aut | |
| 700 | 1 | |a Yamashita, Keiichi |e verfasserin |4 aut | |
| 700 | 1 | |a Utsunomiya, Toshifumi |e verfasserin |4 aut | |
| 700 | 1 | |a Hayashi, Mototaka |e verfasserin |4 aut | |
| 700 | 1 | |a Nakajima, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Hatanaka, Ryo |e verfasserin |4 aut | |
| 700 | 1 | |a Shimada, Daisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Takemura, Atsuhito |e verfasserin |4 aut | |
| 700 | 1 | |a Tabata, Hidefumi |e verfasserin |4 aut | |
| 700 | 1 | |a Tobishima, Hana |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Neurologia medico-chirurgica |d 1964 |g 55(2015), 8 vom: 30., Seite 663-8 |w (DE-627)NLM000580481 |x 1349-8029 |7 nnns |
| 773 | 1 | 8 | |g volume:55 |g year:2015 |g number:8 |g day:30 |g pages:663-8 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.2176/nmc.ra.2014-0386 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 55 |j 2015 |e 8 |b 30 |h 663-8 | ||