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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Delayed cranial nerve palsy after microvascular decompression for hemifacial spasm
Jae-Suk Han1, Jeong-Ah Lee, Doo-Sik Kong
1Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Journal of Korean Neurosurgical Society
|November 8, 2012
Summary
Delayed cranial nerve palsies, including facial palsy, can occur after microvascular decompression for hemifacial spasm. While most cases resolve, rare complications like hearing loss may persist.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Microvascular decompression (MVD) is a standard treatment for hemifacial spasm (HFS).
- Favorable outcomes are generally reported for MVD in HFS treatment.
Purpose of the Study:
- To assess the incidence and clinical course of delayed cranial nerve palsies (VI, VII, VIII) following MVD for HFS.
Main Methods:
- A retrospective review of 1354 patients who underwent MVD for HFS between 1998 and 2009.
- Analysis of patients who developed delayed facial palsy (DFP), sixth nerve palsy, or hearing loss post-MVD.
Main Results:
- Delayed facial palsy (DFP) occurred in 7.4% of patients, with 92% achieving complete recovery.
- Delayed sixth nerve palsy and hearing loss were rare, occurring in one patient each.
- Recovery from DFP averaged 64 days; delayed sixth nerve palsy resolved spontaneously, while hearing loss did not improve.
Conclusions:
- Delayed cranial nerve palsies are possible after MVD for HFS, with DFP being a relatively common complication with a good prognosis.
- Delayed sixth nerve palsy and hearing loss are rare but serious complications that warrant consideration during patient follow-up.
