A nomogram based on clinical multivariate factors predicts delayed cure after microvascular decompression for...

Area of Science:

• Neurosurgery
• Neurology

Background:

• Hemifacial spasm (HFS) outcomes after microvascular decompression (MVD) vary.
• Predicting delayed cure after MVD for HFS is challenging.

Purpose of the Study:

• To develop and validate a nomogram predicting delayed cure probability after MVD in HFS patients.
• To identify key clinical multivariate factors influencing delayed cure.

Main Methods:

• Retrospective analysis of 290 HFS patients undergoing MVD.
• Development of a nomogram using logistic regression in a training cohort (n=232) and validation in a separate cohort (n=58).
• Evaluation of nomogram reliability using ROC and clinical utility via DCA.

Main Results:

• A nomogram was developed incorporating vertebral artery compression, venous compression, absence of LSR, facial nerve indentation, neurovascular compression, and internal auditory canal vascular loops.
• The nomogram demonstrated high predictive accuracy with AUCs of 0.9483 (training) and 0.9382 (validation).
• Calibration and decision curve analyses confirmed the nomogram's good performance and clinical applicability.

Conclusions:

• A validated preoperative and intraoperative nomogram can predict delayed cure after MVD in HFS patients.
• This tool can assist clinicians in comprehensive HFS management.
• The nomogram integrates multiple factors for improved risk stratification.