[Long-term observation on two types of surgical operations for idiopathic hemifacial spasm]

To evaluate and compare the long-term curative effects of two types of surgical operations, microvascular decompression (MVD) and microneurovascular decompression neurocombing neurotraction draw (MVDCTD) for idiopathic hemifacial spasm (IHFS).

Five hundred and fifty-four patients with complete medical records and with at least 3-year followed-up had been collected since 1985.

Of 148 MVD-treated cases with the longest follow-up of 13 years and 9 months, 117 cases were free of symptoms, giving a 79.05% cure rate. Thirty-one patients had recurrence of the symptoms, giving a 20.95% recurrence rate. Of 406 cases treated by MVDCTD with the longest follow-up of 12 years and 3 months, 374 were cured, giving a 92.12% cure rate, and 32 had recurrences of symptoms, giving a 7.88% recurrence rate. Most of them recurred within 2 years after the operation. Complications were sensorineural hearing loss in 31 patients (23 temporary, 8 permanent), temporary tinnitus in 22, temporary postoperative facial weakness in 78, and postoperative meningitis in 34 (3.13%, 33 cases were controlled with antibiotics and 1 patient died).

The vascular compression at the root of the facial nerve is a main cause of IHFS, and the abnormal function of the facial nucleus is also one of the causes. MVDCTD for IHFS is characterized by its high curative rate, low recurrent rate and stable long-term effect, and is superior to the MVD.