Clinical analysis of repeat microvascular decompression for recurrent hemifacial spasm

Predicting outcome of hemifacial spasm after microvascular decompression with intraoperative monitoring: A systematic review

“…A Teflon sponge is then placed into interspace between the facial nerve and offending vessels [47]. Despite some studies had reported effectiveness MVD in relieving spasm [9,10], some reports showed recurrent of spasm due to inadequate nerve decompression or neglected offending vessels [11,12].…”

“…Another review conducted by Miller et al found complete resolution of symptoms as much as 91.1% with an average follow-up of 2.9 years [10]. However, several reports showed the recurrence of spasm due to inadequate nerve decompression or neglected offending vessels, as well as vascular change and slippage of Teflon [11,12].…”

Prediction of hemifacial spasm re-appearing phenomenon after microvascular decompression surgery in patients with hemifacial spasm using dynamic susceptibility contrast perfusion MRI

“…The offending arteries that compress the facial nerve root entry zone (REZ) may include the anterior inferior cerebellar artery (AICA), posterior inferior cerebellar artery (PICA), vertebral artery (VA), or multiple offending arteries. The recurrence of HFS after MVD surgery may be contributed by several factors, such as: The blood flow in their supply area may be reduced by the cumulative effect of compression by multiple perforator arterioles 38 . Reduced blood flow and recurrence may be led by the inappropriate insertion of Teflon, which may fail to absorb the pulse energy or induce local inflammation due to direct compression of the facial REZ 23 .…”

“…However, some patients experience recurrent or persistent symptoms after surgery, which may require reoperation. The second surgery is reported to be more difficult and riskier than the first surgery, due to adhesion, narrow field of view, and nerve stretching injury 16,38,46 . Therefore, it is very important to predict recurrence of HFS after the first surgery.…”

반얼굴연축에서 미세혈관감압 수술중 신경계감시

“…In this situation, when the other vessel is identified and moved off the facial nerve, the LSR disappears [4]. Although there are a few cases, persistent symptoms or recurrence of spasm were noticed even after surgery for reasons of Teflon felt factor and vascular change, as well as inadequate decompression or neglected offending vessels [12,13]. In some cases, it may take about 1 year after MVD for HFS disappearance, this phenomenon supports the central mechanism theory of HFS development including facial motor nucleus hyperexcitability [4].…”