期刊
LIFE-BASEL
卷 13, 期 10, 页码 -出版社
MDPI
DOI: 10.3390/life13102064
关键词
hemifacial spasm; neurovascular compression; vein; cisternal
This study investigated the outcomes of microvascular decompression (MVD) surgery in patients with hemifacial spasm (HFS) who did not show definite neurovascular compression (NVC) on preoperative MRI. The most common vessel compressing the facial nerve was the AICA, and the most common compression site was the cisternal portion of the facial nerve. All patients experienced symptom improvement after the surgery, with only one patient showing recurrence.
The purpose of this study was to investigate the outcome of microvascular decompression (MVD) in patients with hemifacial spasm (HFS) who have no definite radiological neurovascular compression (NVC). Sixteen HFS patients without radiological NVC on preoperative MRI underwent MVD surgery. The symptoms were left-sided in fourteen (87.5%) and right-sided in two patients (12.5%). Intraoperatively, the most common vessel compressing the facial nerve was the AICA (8, 44.4%), followed by arterioles (5, 27.8%), veins (4, 22.2%), and the PICA (1, 5.6%). The most common compression site was the cisternal portion (13, 76.5%) of the facial nerve, followed by the REZ (4, 23.5%). One patient (6.3%) was found to have multiple NVC sites. Arachnoid type (7, 50%) was the most common compressive pattern, followed by perforator type (4, 28.6%), sandwich type (2, 14.3%), and loop type (1, 7.1%). A pure venous compression was seen in two patients, while a combined venous-arterial sandwich compression was detected in two patients. Symptom improvement was observed in all of the patients. Only one patient experienced recurrence after improvement. Based on our experience, MVD surgery can be effective for primary HFS patients with no definite radiological NVC. MVD can be considered if the patient shows typical HFS features, although NVC is not evident on MRI.
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