Microvascular decompression for patients with facial spasm:a report of 187 cases and literature review

SHEN Yan-jie; CHENG Dong-liang; CHENG Wen-ping; REN Rui-ming; ZHANG Kun

doi:10.13798/j.issn.1009-153X.2024.09.006

Abstract：Objective To explore the surgical methods and clinical efficacy of microvascular decompression for patients with facial spasm. Methods The clinical data of 187 patients with hemifacial spasm treated by microvascular decompression from January 2018 to July 2022 were retrospectively analyzed. Results The anterior inferior cerebellar artery was identified as the responsible vessels during the operation in 81 patients (43.3％),the posterior inferior cerebellar artery in 39 (20.9％),and multiple vessels in 67 (35.8％). Of these 187 patients,178 patients (95.2％) had complete disappearance of symptoms immediately after the operation,and 9 (4.8％) had gradual disappearance within 2 weeks to 3 months after the operation. Three patients developed tinnitus after the operation and gradually recovered after one month;1 had hearing loss and did not recover;8 had mild facial paralysis and recovered after treatment with neurotrophic drugs combined with local acupuncture and hyperbaric oxygen therapy;3 had moderate fever,and the body temperature returned to normal after 3 to 5 days of intravenous dexamethasone administration;1 had cerebrospinal fluid leakage from the wound and healed after conservative treatment such as local pressure dressing. There were no complications such as intracranial infection and intracerebral hemorrhage after the operation,and no surgical deaths occurred. Conclusion Microvascular decompression is a mature surgical method for the treatment of hemifacial spasm. Skilled microsurgical operation during the operation,identification of the responsible vessels,and good intraoperative monitoring to avoid excessive traction are the keys to improving the cure rate and reducing complications.