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Acta Neurochirurgica

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01-11-2020 | Original Article - Functional Neurosurgery - Pain

Flat-shaped posterior cranial fossa was associated with poor outcomes of microvascular decompression for primary hemifacial spasm

Authors: Kai Zhao, Junwen Wang, Weihua Liu, Jiaxuan Zhang, Kai Shu, Ting Lei

Published in: Acta Neurochirurgica | Issue 11/2020

Abstract

Background

Numerous factors have been investigated on affecting the outcomes of primary hemifacial spasm (HFS) after microvascular decompression (MVD). It is well established that anatomical differences of the posterior cranial fossa (PCF) plays an important role in the occurrence of HFS. However, it is still not clear whether morphological characteristics of PCF affect the surgical outcomes of HFS after MVD. Our study aims to investigate the prognostic factors for surgical outcomes of MVD for primary HFS, with a particular focus on the morphological characteristics of PCF.

Methods

Between January 2014 and November 2017, a total of 152 HFS patients who underwent MVD treatment in our department were included in this study. The clinical data were retrospectively reviewed. The outcomes of MVD were classified into success and failure groups according to the short- and long-term postoperative responses. Particularly, we established an ellipsoid model for PCF. The related length (Y), width (X) and height (Z) of the PCF were measured and the volume of PCF was calculated employing a formula of \( \frac{\uppi}{6} \)XYZ. The relationship between PCF volume and surgical outcomes was statistically analysed.

Results

The severity of neurovascular compression (NVC) (p = 0.010), type of NVC (p = 0.001) and lateral spread response (LSR) (p < 0.0001) significantly influenced the long-term surgical outcomes of MVD for primary HFS. In particular, for the first time, we demonstrated that a flat-shaped PCF was associated with poor long-term outcome and postoperative recurrence.

Conclusions

Our current study suggests that mild NVC, small vessel compression, intraoperative LSR persistence and flat-shaped PCF are independent factors predicting poor prognosis of MVD for primary HFS.

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Title: Flat-shaped posterior cranial fossa was associated with poor outcomes of microvascular decompression for primary hemifacial spasm
Authors: Kai Zhao
Junwen Wang
Weihua Liu
Jiaxuan Zhang
Kai Shu
Ting Lei
Publication date: 01-11-2020
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 11/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04547-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Flat-shaped posterior cranial fossa was associated with poor outcomes of microvascular decompression for primary hemifacial spasm

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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