Factors Affecting Surgical Complexity of Microvascular Decompression for Hemifacial Spasm

Area of Science:

• Neurosurgery
• Neurology

Background:

• Hemifacial spasm is a neurological disorder characterized by involuntary facial muscle contractions.
• Microvascular decompression (MVD) is a primary surgical treatment for hemifacial spasm, aiming to alleviate neurovascular compression.

Purpose of the Study:

• To evaluate the surgical complexity of microvascular decompression for hemifacial spasm by analyzing procedure duration.
• To identify patient-specific and procedural factors influencing surgical time.

Main Methods:

• Retrospective analysis of 127 patients undergoing MVD for hemifacial spasm.
• Surgical time divided into craniotomy, microscopic procedure, and closure phases.
• Analysis of durations based on age, sex, BMI, mastoid air cell opening, and mobilized arteries (AICA, PICA, VA).

Main Results:

• Total surgical time was significantly shorter in patients aged ≥65 years and in women.
• Sex significantly impacted craniotomy and closure durations; closure time increased with mastoid air cell opening.
• Microscopic procedure time was shorter in older patients; vertebral artery involvement and multiple artery mobilization trended towards longer durations.

Conclusions:

• Surgical duration in MVD for hemifacial spasm is influenced by patient demographics like age and sex.
• Craniotomy and closure complexity may be higher in males with large mastoid air cells.
• Intradural complexities should be anticipated irrespective of the identified culprit artery.