Advances in microvascular decompression for hemifacial spasm

Cui, Zhiqiang; Ling, Zhipei

doi:10.1016/j.joto.2015.06.002

Cited by 7 publications

(5 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neurovascular compression (NVC) is the main cause of primary trigeminal neuralgia (TN) or hemifacial spasm (HFS), and frequently occurs at the root entry zone (REZ) of cranial nerves ( 1 ). Microvascular decompression (MVD) is an effective surgical treatment for TN and HFS caused by NVC ( 2 , 3 ). However, preoperative detection of NVC is occasionally difficult.…”

Section: Introductionmentioning

confidence: 99%

3D multimodal image fusion based on MRI in the preoperative evaluation of microvascular decompression: A meta‑analysis

Liang

Yang²,

Zhang

et al. 2023

Exp Ther Med

View full text Add to dashboard Cite

Neurovascular compression (NVC) is the main cause of hemifacial spasm (HFS) or trigeminal neuralgia (TN), and frequently occurs at the root entry zone of cranial nerves. Microvascular decompression (MVD) is an effective surgical treatment for TN and HFS caused by NVC. The accurate preoperative diagnosis of NVC is crucial to the evaluation of MVD as an appropriate treatment for TN and HFS. Three-dimensional (3D) time-of-flight magnetic resonance angiography (3D TOF MRA) and high resolution T2-weighted imaging (HR T2WI) are used to detect NVC prior to MVD; however, this combination alone has certain disadvantages. Multimodal image fusion (MIF) may combine two or more images from the same or different modalities, allowing neurosurgeons to use the reconstructed 3D model to observe anatomical details more clearly from different perspectives. The aim of the present meta-analysis was to evaluate the effect of 3D MIF based on 3D TOF MRA combined with HR T2WI in the preoperative diagnosis of NVC, and thus to evaluate its clinical application value in the preoperative evaluation of MVD. Relevant studies available on PubMed, Embase, Web of Science, Scopus, China National Knowledge Infrastructure and the Cochrane Library, and published from the inception of each database to September 2022, were retrieved. Studies using 3D MIF based on 3D TOF MRA combined with HR T2WI to diagnose NVC in patients with TN or HFS were included. The Quality Assessment of Diagnostic Accuracy Studies checklist was used to evaluate the quality of the included studies. The statistical software Stata 16.0 was used to perform the meta-analysis. Data extraction was performed by two independent investigators and discrepancies were resolved by discussion. Pooled sensitivities, specificities, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the receiver operating characteristic curve (AUROC) were calculated as the main summary effect size. The I² and Q-test were used to assess heterogeneity. The present search identified 702 articles, of which 7 (comprising 390 patients) fulfilled the inclusion criteria. Bivariate analysis indicated that the pooled sensitivity and specificity of 3D MIF based on 3D TOF MRA combined with HR T2WI for detecting NVC were 0.97 (95% CI, 0.95-0.99) and 0.89 (95% CI, 0.77-0.95), respectively. The pooled PLR was 8.8 (95% CI, 4.1-18.6), the pooled NLR was 0.03 (95% CI, 0.02-0.06) and the pooled DOR was 291 (95% CI, 99-853). The AUROC was 0.98 (95% CI, 0.97-0.99). The studies had no substantial heterogeneity (I 2 =0; Q=0.000; P=0.50). The present results suggested that 3D MIF based on 3D TOF MRA combined with HR T2WI had excellent sensitivity and specificity for diagnosing NVC in patients with TN or HFS. Therefore, this method should serve a key role in MVD preoperative evaluation.

show abstract

Section: Introductionmentioning

confidence: 99%

3D multimodal image fusion based on MRI in the preoperative evaluation of microvascular decompression: A meta‑analysis

Liang

Yang²,

Zhang

et al. 2023

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…Neurovascular compression (NVC) is considered the main cause of primary trigeminal neuralgia (TN) and hemifacial spasm (HFS), which usually occurs in the root entry zone (REZ) of the trigeminal nerve or facial nerve[ 1 , 2 ]. Microvascular decompression (MVD) is an effective surgical method for treating TN and HFS caused by NVC[ 3 , 4 ]. Although this operation is safe and effective for skillful and experienced neurosurgeons, it does not seem to be the best choice for patients with TN or HFS not caused by NVC[ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional time-of-flight magnetic resonance angiography combined with high resolution T2-weighted imaging in preoperative evaluation of microvascular decompression

Liang¹,

Yang²,

Zhang³

et al. 2022

World J Clin Cases

View full text Add to dashboard Cite

BACKGROUND Neurovascular compression (NVC) is the main cause of primary trigeminal neuralgia (TN) and hemifacial spasm (HFS). Microvascular decompression (MVD) is an effective surgical method for the treatment of TN and HFS caused by NVC. The judgement of NVC is a critical step in the preoperative evaluation of MVD, which is related to the effect of MVD treatment. Magnetic resonance imaging (MRI) technology has been used to detect NVC prior to MVD for several years. Among many MRI sequences, three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) is the most widely used. However, 3D TOF MRA has some shortcomings in detecting NVC. Therefore, 3D TOF MRA combined with high resolution T2-weighted imaging (HR T2WI) is considered to be a more effective method to detect NVC. AIM To determine the value of 3D TOF MRA combined with HR T2WI in the judgment of NVC, and thus to assess its value in the preoperative evaluation of MVD. METHODS Related studies published from inception to September 2022 based on PubMed, Embase, Web of Science, and the Cochrane Library were retrieved. Studies that investigated 3D TOF MRA combined with HR T2WI to judge NVC in patients with TN or HFS were included according to the inclusion criteria. Studies without complete data or not relevant to the research topics were excluded. The Quality Assessment of Diagnostic Accuracy Studies checklist was used to assess the quality of included studies. The publication bias of the included literature was examined by Deeks’ test. An exact binomial rendition of the bivariate mixed-effects regression model was used to synthesize data. Data analysis was performed using the MIDAS module of statistical software Stata 16.0. Two independent investigators extracted patient and study characteristics, and discrepancies were resolved by consensus. Individual and pooled sensitivities and specificities were calculated. The I² statistic and Q test were used to test heterogeneity. The study was registered on the website of PROSERO (registration No. CRD42022357158). RESULTS Our search identified 595 articles, of which 12 (including 855 patients) fulfilled the inclusion criteria. Bivariate analysis showed that the pooled sensitivity and specificity of 3D TOF MRA combined with HR T2WI for detecting NVC were 0.96 [95% confidence interval (CI): 0.92-0.98] and 0.92 (95%CI: 0.74-0.98), respectively. The pooled positive likelihood ratio was 12.4 (95%CI: 3.2-47.8), pooled negative likelihood ratio was 0.04 (95%CI: 0.02-0.09), and pooled diagnostic odds ratio was 283 (95%CI: 50-1620). The area under the receiver operating characteristic curve was 0.98 (95%CI: 0.97-0.99). The studies showed no substantial heterogeneity ( I 2 = 0, Q = 0.001 P = 0.50). CONCLUSION Our results suggest t...

show abstract

“…[ 3 , 4 ] Although there are microsurgery treatment options available, because of potential complications patients may prefer a less invasive treatment modality. [ 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

“…The condition is usually chronic and progressive and may cause patients significant social embarrassment and sometimes interfere with vision from involuntary eye closure [3,4] . Although there are microsurgery treatment options available, because of potential complications patients may prefer a less invasive treatment modality [5,6] …”

Section: Introductionmentioning

confidence: 99%

“…[3,4] Although there are microsurgery treatment options available, because of potential complications patients may prefer a less invasive treatment modality. [5,6] FS results from abnormal, involuntary facial muscle contraction during voluntary facial movement of a different group of facial muscles. This phenomenon is seen after recovery from facial nerve injury.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term stable efficacy of botulinum toxin A in facial movement disorders with no need for increasing dose

Badarny

Ibrahim

Susel³

et al. 2021

Medicine

View full text Add to dashboard Cite

Botulinum toxin A is considered an effective treatment for involuntary facial movements. We examined whether treatment efficacy maintained or changed over time with two products, Botox and Dysport, in patients with hemifacial spasm, facial synkinesis and benign essential blepharospasm. We retrospectively investigated 87 consecutive patients (51 women, 36 men) who had undergone treatment for ≥6 years. Long-term effects, as well as side effects of Botox or Dysport local injections were evaluated. The first three treatments were considered the titration period and not taken into account when testing for dose changes. Mean treatment duration was 10 years (range 6–11, SD 1.0), 2441 treatments were administered, 1162 with Botox and 1279 with Dysport, the two brands were interchanged as needed. Good to full improvement was seen in 90% of patients both with both brands. Injection doses and treatment responses were consistent during the study with both drugs. No major side effects were reported, and relatively few minor adverse events were reported, with clear reduction from the titration period (6.1%), to the remainder of the study (3.9%). Botulinum toxin (BTX-A) is a satisfactory long-term treatment without need for dose increase over. Both Botox and Dysport were effective when used interchangeably.

show abstract

Advances in microvascular decompression for hemifacial spasm

Cited by 7 publications

References 32 publications

3D multimodal image fusion based on MRI in the preoperative evaluation of microvascular decompression: A meta‑analysis

3D multimodal image fusion based on MRI in the preoperative evaluation of microvascular decompression: A meta‑analysis

Three-dimensional time-of-flight magnetic resonance angiography combined with high resolution T2-weighted imaging in preoperative evaluation of microvascular decompression

Long-term stable efficacy of botulinum toxin A in facial movement disorders with no need for increasing dose

Contact Info

Product

Resources

About