Long-Term Outcome of Repeat Microvascular Decompression for Hemifacial Spasm

Area of Science:

• Neurosurgery
• Neurology

Background:

• Hemifacial spasm (HFS) often requires repeat microvascular decompression (MVD) when initial surgery fails.
• Long-term outcomes and complication profiles of repeat MVD for HFS are not well-established.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of repeat MVD in patients with HFS who previously underwent MVD.
• To identify factors influencing outcomes after repeat MVD.

Main Methods:

• A cohort of 78 patients underwent repeat MVD for HFS, with 58 available for long-term follow-up (median 8.6 years).
• Data collected included intraoperative findings, immediate and long-term relief of spasms, and complication rates.
• Statistical analysis explored correlations between preoperative characteristics and outcomes.

Main Results:

• At discharge, 92.3% achieved complete spasm resolution; at long-term follow-up, 77.6% had complete relief and 17.2% improved relief.
• Short-term complications occurred in 9% of patients; permanent complications in 24.1% (hearing loss, hemifacial paresis most common).
• Despite complications, 91.4% reported excellent quality of life; no significant correlation found between preoperative factors and outcomes.

Conclusions:

• Repeat MVD is an effective treatment for persistent or recurrent HFS, providing lasting relief for the majority of patients.
• The procedure is associated with a considerable rate of complications, necessitating careful patient selection and management.