Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy
Open Access
- 1 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Scientific Reports
- Vol. 11 (1), 1-7
- https://doi.org/10.1038/s41598-021-84347-x
Abstract
The vertebral artery (VA)-involved hemifacial spasm (HFS) has distinctive clinical features and performing microvascular decompression (MVD) is challenging. We described the clinical presentations of VA-involved HFS and the outcomes of MVD using the interposition method. Between January 2008 and March 2015, MVD was performed in 271 patients with VA-involved HFS. Demographic characteristics, preoperative severity, intraoperative findings, spasm-free outcome, and complications were retrospectively evaluated. A control group of 1500 consecutive patients with non-VA-involved HFS was enrolled. VA-involved HFS was associated with older age (p < 0.001), less female predominance (p < 0.001), more left-sided predominance (p < 0.001), and rapid symptom progression before MVD (p < 0.001). The Teflon Fulcrum method allowed intraoperative identification of the neurovascular compression site in 92.6% of the cases, and showed more severe indentation on the facial nerve (p < 0.001). Changes in the brainstem auditory evoked potentials during MVD (p < 0.001) and postoperative non-serviceable hearing loss (p < 0.001) were more frequent in patients with VA-involved than in non-VA-involved HFS. The spasm-free outcome and overall complication rates after MVD were not significantly different between the groups. VA-involved HFS has distinctive clinical features and poses a major surgical challenge for MVD success. The interposition method is a feasible surgical strategy in VA-involved HFS.This publication has 33 references indexed in Scilit:
- Hemodynamic Characteristics of the Vertebrobasilar System Analyzed Using MRI-Based ModelsPLOS ONE, 2012
- Outcomes of surgical treatment for hemifacial spasm associated with the vertebral artery: severity of compression, indentation, and color changeActa Neurochirurgica, 2011
- “Double-Stick Tape” Technique for Transposition of an Offending Vessel in Microvascular Decompression: Technical Case ReportOperative Neurosurgery, 2011
- Stitched sling retraction technique for microvascular decompression: procedures and techniques based on an anatomical viewpointNeurosurgical Review, 2011
- Microvascular decompression for treating hemifacial spasm: lessons learned from a prospective study of 1,174 operationsNeurosurgical Review, 2010
- Prognostic Factors of Hemifacial Spasm after Microvascular DecompressionJournal of Korean Neurosurgical Society, 2009
- Microvascular Decompression for Hemifacial Spasm Associated with Vertebrobasilar ArteryJournal of Korean Neurosurgical Society, 2008
- Use of fenestrated aneurysm clips in microvascular decompression surgeryJournal of Neurosurgery, 2007
- Microvascular decompression for hemifacial spasm caused by the vertebral artery: a simple and effective transposition method using surgical glueSurgical Neurology, 2004
- Repositioning of the vertebral artery as treatment for neurovascular compression syndromesJournal of Neurosurgery, 1997