Espasmo hemifacial resultados da descompressão microvascular em 53 pacientes

Abstract

In a ten year period 53 patients with hemifacial spasm were submitted to 54 microvascular decompression procedures in the posterior fossa. The technique was the same developed by Jannetta and the initial surgical results were considered excellent in 91% of the cases. The follow-up ranges from 60 days to 7 years, with 40 patients followed for more than two years and 16 for more than five years. Only one patient presented late recurrence of the spasms. There was no death nor serious complications which were usually transient and related do the seventh and eight nerve. In four patients we found no compression of the nerve root. We concluded that no matter what the causes of hemifacial spasm or the mechanisms of action of the surgery are the results of microvascular decompression are excellent and superior to all other clinical and surgical methods of treatment.

Tenth case of bilateral hemifacial spasm treated by microvascular decompression: Review of the pathophysiology

“…To our knowledge, only 102 cases of BHFS have been reported [ Table 2 ],[ 6 13 19 31 47 55 56 57 72 81 86 92 94 100 105 ] and of these, only 10 cases were submitted to bilateral MVD, including our case. [ 6 13 81 ]…”

“…The spasms begin in adult life, around 45 years of age, and prior history of peripheral facial paralysis or traumatic nerve injury is not uncommon. [ 6 16 17 24 44 55 72 ] In a large series, motor nerve dysfunction was verified in 57% of cases. [ 6 ] Synkinesis has been reported in 70% of cases with HFS.…”

“…The best long-term therapeutic response for HFS due to NVC is endoscope[ 9 58 ] or microscope-assisted MVD. [ 6 34 49 54 60 63 72 107 109 ] MVD is the only option for curing HFS. [ 49 63 109 ] Improvement in the spasms can occur immediately following MVD or may take several months.…”