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Acta Neurochirurgica

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01-12-2010 | Clinical Article

Microneurovascular decompression in patients with hemifacial spasm caused by vascular compression of facial nerve at cisternal portion

Authors: Won Seok Chang, Hae Yu Kim, Sang Sup Chung, Jin Woo Chang

Published in: Acta Neurochirurgica | Issue 12/2010

Abstract

Background

Hemifacial spasm is commonly caused by arterial compression of the facial nerve. Although vascular compression usually occurs at the facial nerve exit zone, in some cases, the facial nerve is compressed more distally. We analyzed the clinical outcome of microneurovascular decompression in patients with hemifacial spasm caused by either distal or proximal compression.

Method

From September 1978 to March 2009, 2,137 patients underwent microneurovascular decompression for hemifacial spasm due to vascular compression of the facial nerve, including 2,022 patients (94.6%) with proximal compression, 101 patients (4.7%) with both proximal and distal (mixed) compression, and 14 patients (0.7%) with only distal compression.

Findings

Complete remission of facial spasm occurred in 10 of 14 patients (71.4%) with compression of the cisternal portion, compared with 1,773 of 2,022 patients (87.7%) with proximal compression (P = 0.08) and 87 of 101 patients (86.1%) with mixed compression (P = 0.23). Permanent facial weakness occurred in one patient (7.1%) with compression of the cisternal portion, 18 patients (0.9%) with proximal compression, and one patient (1.0%) with mixed compression. Permanent hearing loss occurred in no patients with compression of the cisternal portion, 29 patients (1.4%) with proximal compression, and three patients (3.0%) with mixed compression.

Conclusions

Outcomes after microneurovascular decompression for hemifacial spasm with compression of the cisternal portion were not statistically different than with proximal compression of the facial nerve. When the clinical diagnosis of hemifacial spasm is confirmed and vascular compression is seen only in the cisternal portion of the facial nerve, microneurovascular decompression for these patients provides outcomes similar to those with proximal compression of the facial nerve.

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Title: Microneurovascular decompression in patients with hemifacial spasm caused by vascular compression of facial nerve at cisternal portion
Authors: Won Seok Chang
Hae Yu Kim
Sang Sup Chung
Jin Woo Chang
Publication date: 01-12-2010
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 12/2010
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-010-0826-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Microneurovascular decompression in patients with hemifacial spasm caused by vascular compression of facial nerve at cisternal portion

Abstract

Background

Method

Findings

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Findings

Conclusions

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