Reconstruction of the Craniectomy Site with the Bone Chips in Patients with Hemifacial Spasm

OBJECTIVE: This study is designed to demonstrate a relationship between reconstruction methods of the craniectomy site and the development of postoperative complications including headache, tinnitus, and operation site pain after microvascular decompression(MVD) in patients with hemifacial spasm. METHODS: This study included 44 consecutive patients who underwent MVD due to hemifacial spasm from 1995 to 2001. Craniectomy site was reconstructed with only Gelfoam(group 1) in 20, the bone dust and Gelfoam(group 2) in 11, the bone chips and Gelfoam(group 3) in 13. Group 1, 2 were studied retrospectively and group 3 was studied prospectively on the postoperative complications. RESULTS: Postoperatively, wound infection occurred in 3(6.8%), headache in 14(31.8%), operation site pain in 17(38.6%), tinnitus in 15(34.1%), hearing loss in 1(2.2%). Wound infection was noticed in 5% of group 1, 18.2% of group 2, and none of group 3. Headache developed in 45% of group 1, 27.3% of group 2, and 15.4% of group 3. Operation site pain was noticed in 50% of group 1, 27.3% of group 2, 15.4% of group 3. Tinnitus revealed in 45% of group 1, 18.2% of group 2, 30% of group 3. CONCLUSION: Reconstruction of the craniectomy site with the bone chips in patients with hemifacial spasm might have effects on diminution of the postoperative headache, operation site pain and wound infection.

Hemangiopericytoma Recurred at the Distant Area

Hemangiopericytomas, which used to be classified as the subtype of the meningiomas, like the angioblastic meningiomas or hemangiopericytic meningiomas, are rare in the central nervous system with an incidence of <1% of all central nervous system(CNS) tumors. In spite of a total surgical removal, hemangiopericytomas have a tendency of high local recurrence and distant metastasis. The authors report a case of hemaniogipericytoma recurred at the remote area from the primary site. The tumor recurred in the meninges of right temporal area after total removal of the tumor in the right parasaggital region including the falx.