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Updated: Dec 13, 2025
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Predictive value of intraoperative blink reflex monitoring for surgical outcome during microvascular decompression
Jongsuk Choi1, Sejin Yang1, Jun-Soon Kim1
1Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul,Republic of Korea.
Objective:
To investigate the prognostic and predictive value of intraoperative blink reflex (BR) monitoring during microvascular decompression (MVD) for hemifacial spasm (HFS).
Methods:
We retrospectively reviewed 41 patients with HFS undergoing MVD with intraoperative BR and lateral spread response (LSR) monitoring. Facial spasm was evaluated for six months postoperatively.
Results:
The BR resolved in 38 patients and persisted in three after MVD. For patients who exhibited BR resolution, 1-day, 1-month, and 6-month follow-ups revealed that 35 (92.1%), 35 (92.1%), and 38 (100%) patients had spasm resolution, respectively. However, of the three patients with persistent BR, one (33.3%), one (33.3%), and zero (0%) patients exhibited spasm resolution at the three corresponding follow-ups. We found a statistically significant difference in spasm resolution between the persistent and resolved BR groups at six months postoperatively. A comparison between intraoperative BR and LSR monitoring revealed that BR was a better predictor of clinical outcomes.
Conclusions:
Intraoperative BR monitoring is a potentially useful tool to help facilitate an adequate decompression and is a reliable prognostic predictor of surgical outcome.
Significance:
This study is the first to document the relationship between intraoperative BR monitoring and surgical outcome in patients with HFS.
