A Proposal for Standardized Analysis of Microvascular Decompression Results in Hemifacial Spasm

This study aimed to evaluate subjective satisfaction using a grading system based on postoperative spasm relief and complication rates, reflecting the perceptions of physicians and patients.

Patients with hemifacial spasm who underwent microvascular decompression (MVD) and were followed up for 2-15 years were enrolled. Subjective satisfaction was assessed using two scores: the spasm score (E), which categorized residual spasms from E-0 (complete relief) to E-3 (persistent spasms), and the complication score (C), which ranged from C-0 (no complications) to C-2 (severe nerve dysfunction). The sum of E and C scores represented overall patient satisfaction (T).

Among 152 patients, spasm scores were E-0 in 118 (77.6%), E-1 in 29 (19.0%), and E-2 or E-3 in 5 (3.2%). Complications were scored as C-0 in 112 patients (73.7%), with C-1 and C-2 observed in 40 (26.3%). Overall satisfaction scores were T-0 in 89 patients (58.6%), T-1 in 41 (26.9%), T-2 in 18 (11.8%), and T-3 in 4 (2.6%).

A standardized analysis of MVD outcomes in hemifacial spasm is essential to evaluate not only patient-reported satisfaction but also to integrate spasm relief, symptom persistence, complications, and recurrence into a single score. MVD results should be assessed through comprehensive satisfaction metrics incorporating subjective evaluations from patients and surgeons.