[Microsurgical facial nerve decompression for hemifacial spasm]

ABSTRACT

The results of a series of 8 patients with hemifacial spasm [HFS], treated with microsurgical vascular decompression [MVD] are reported. A magnetic resonance imaging [MRI] of the brain was performed in all patients prior to surgical. The presence of arterial hypertension [HT] was noted. MVD was performed through a retromastoid approach, and Gortex [rigestrited sign] was interposed between the nerve and the conflicting vessel. The offending vessels found were the antero-inferior cerebellar artery in 50% of the cases, the postero-inferior cerebellar artery in 25% and the vertebral artery in 25%. These findings were positively correlated with MRI in only 50% of cases. The surgical resultes were the following total and immediate relief in 62.5% of cases, delayed relief in 25%, and partial relief in 12.5%. Neither failure, nor recurrence were noted. In terms of complications, two cases of persisting hearing loss, one case of transient hearing loss, and two cases of persisting facial palsy. Hypertension improved in 20% of cases. This study shows the success of MVD in the treatment of HFS. Intraoperative monitoring is helpful in reducing the complication rate. In our practice, the correlation between MRI findings and surgery was poor, as opposed to the results found in literature