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Reoperation for persistent or recurrent hemifacial spasm after microvascular decompression.
Yong S Park1, Jong H Chang, Joon Cho
1Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
Neurosurgery
|May 26, 2006
Summary
Repeat microvascular decompression (MVD) effectively treats persistent or recurrent hemifacial spasm (HFS) in selected patients. Three-dimensional MRA aids in identifying offending vessels for successful reoperation.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Microvascular decompression (MVD) is a primary treatment for hemifacial spasm (HFS).
- Some patients experience persistent or recurrent HFS after initial MVD, necessitating further intervention.
Purpose of the Study:
- To evaluate the efficacy and outcomes of reoperation for persistent or recurrent HFS following initial MVD.
- To assess the role of three-dimensional short-range magnetic resonance angiography (3D-SRMRA) in patient selection for repeat MVD.
Main Methods:
- A cohort of 13 patients with persistent or recurrent HFS underwent repeat MVD.
- Patient selection for repeat MVD was based on the identification of compressing vessels via postoperative 3D-SRMRA.
Main Results:
- All six patients with no initial improvement experienced excellent results after repeat MVD.
- Of six patients with initial relief followed by recurrence, four had excellent, one good, and one fair outcome after reoperation.
- Two patients (15.4%) experienced mild adverse effects (facial weakness, hearing impairment) with no serious morbidity.
Conclusions:
- Repeat MVD is a viable and effective treatment option for selected patients with persistent or recurrent HFS.
- 3D-SRMRA is a valuable tool for identifying causative vessels and guiding patient selection for repeat MVD.