Abstract:

Objective To investigate the therapeutic effect of microvascular decompression surgery on idiopathic hemifacial spasm with compression on different zones of facial nerve. Methods The clinical data of 548 patients with idiopathic hemifacial spasm treated by microvascular decompression surgery were retrospectively analysed. Patients were divided into 5 groups according to compression on different zones of facial nerve by offending vessels. Root exit point was compressed in 31 patients (group A), transitional zone of brainstem was compressed in 59 patients (group B), attached segment of brainstem was compressed in 47 patients (group C), distal cisternal portion was compressed in 28 patients (group D), and two or more zones were compressed in 383 patients (group E). The therapeutic effect was observed, and complete remission and partial remission were regarded as effectiveness. Results Patients were followed up for 0.5 to 2 years. The effective rates were 96.8%, 96.6%, 97.8%, 96.4% and 94.5% in group A, group B, group C, group D and group E respectively. No death occurred in operation, and there were no severe complications such as complete facial paralysis, intracranial hematoma and hearing loss after operation. Conclusion Microvascular decompression surgery is the first choice for treatment of patients with hemifacial spasm. Proper detection of offending vessels and complete decompression may be the key factors to increase the cure rate.

Key words: hemifacial spasm, microvascular decompression, facial nerve