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Updated: Jun 11, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
The efficacy and safety of microvascular decompression for hemifacial spasm in elderly patients
Chul-Jin Jeon1, Doo-Sik Kong, Jeong-A Lee
1Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Objective:
The purpose of this study was to examine the efficacy and safety of microvascular decompression (MVD) for hemifacial spasm (HFS) in elderly patients.
Methods:
Between 1997 and June 2008, 1,174 patients had undergone MVD for HFS at our institute. Among these, 53 patients were older than 65 years. We retrospectively reviewed and compared the complication and the cure rates of these patients with those of younger patients.
Results:
There were 38 females and 15 males. The mean duration of symptoms of HFS of these patients was 94.6 months (range, 12-360 months), compared with 67.2 months (range, 3-360 months) in the younger group. The overall cure rate in elderly patients who underwent MVD for HFS during this period was 96.2%. Permanent cranial nerve dysfunctions, such as hearing loss and facial palsy, were seen in 2 patients (3.8%, 2/53) in the elderly group and 19 patients (1.7%, 19/1121) in the younger group. The difference in permanent cranial nerve dysfunction between the two groups was not statistically significant. There was no operative mortality in either group.
Conclusion:
Microvascular decompression is the most effective surgical modality available for the treatment of HFS. Results of this study indicate that such technique can be performed in the elderly without higher rates of morbidity or mortality. Any patient with HFS, whose general health is acceptable for undergoing general anesthesia, should be considered as a candidate for MVD.
Insights
Microvascular decompression (MVD) is safe and effective for elderly patients with hemifacial spasm (HFS). This procedure offers high cure rates with comparable complication risks to younger patients, making it a viable option for eligible seniors.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Hemifacial spasm (HFS) is a neurological disorder characterized by involuntary contractions of facial muscles.
- Microvascular decompression (MVD) is a surgical treatment that addresses the neurovascular compression causing HFS.
Purpose of the Study:
- To evaluate the efficacy and safety of MVD for treating hemifacial spasm (HFS) specifically in elderly patients (over 65).
Main Methods:
- Retrospective review of 1,174 patients who underwent MVD for HFS between 1997 and June 2008.
- Comparison of complication and cure rates between 53 elderly patients and younger patients.
Main Results:
- Elderly patients achieved a high overall cure rate of 96.2% for HFS.
- Permanent cranial nerve dysfunction occurred in 3.8% of elderly patients versus 1.7% of younger patients, a statistically insignificant difference.
- No operative mortality was observed in either the elderly or younger patient groups.
Conclusions:
- Microvascular decompression (MVD) is a highly effective treatment for hemifacial spasm (HFS) in elderly individuals.
- MVD can be safely performed in elderly patients with acceptable morbidity and mortality rates.
- Elderly patients with HFS and acceptable general health for anesthesia should be considered candidates for MVD.
