Efficacy and Complications of Microsurgical Neurovascular Decompression in 55 Patients With Hemifacial Spasm

Compagnon, Chloé; Labrousse, M.; Brenet, Esteban; Chays, A.; Bazin, Arnaud; Kleiber, Jean‐Charles; Dubernard, Xavier

doi:10.1177/0194599820969168

Cited by 5 publications

(2 citation statements)

References 39 publications

(90 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Though IPV diameter varies greatly among patients, in most cases of the sacrifice group, the diameters were generally smaller (i.e., <1 mm). There are two plausible reasons for this-first, a smaller IPV is difficult to protect because of its thin and fragile wall, which is more prone to tearing; second, sometimes experienced surgeons opt to deliberately sacrifice an IPV with small diameters in order to achieve wider exploration (13,14). A small diameter indicates that the draining area of the IPV is more limited, meaning that any injury to the vessel is likely to have little effect on the patient.…”

Section: Perspectives On Ipv Diametermentioning

confidence: 99%

“…During this procedure, we sometimes encounter IPV which obstructs the operation field. Although some experienced experts sacrifice IPV under this situation with no apparent postoperative complication (13,14), it is reasonable to keep any of the vessels intact with the accomplishment of MVD surgery. Besides, the considerable variation of the inferior petrosal vein and its anatomic features have not been analyzed yet.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative Findings of Inferior Petrosal Vein During Microvascular Decompression for Hemifacial Spasm: A Single-Surgeon Experience

Wang

Zhang

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

ObjectiveThis study aims to evaluate the impact of the inferior petrosal veins (IPVs) on operational exploration and to analyze related anatomic features.MethodsA total of 317 patients were retrospectively studied. Surgical outcomes and postoperative complications were analyzed, and patients were divided into two groups according to whether the IPV was sacrificed or preserved. The diameter of the IPV was also recorded during operation. Furthermore, the position where the IPV drained into the jugular bulb was recorded in each patient, and the influence of different injection points on the operation was analyzed.ResultsIPVs were conclusively identified in 242/317 (76.3%) of patients, with 110/242 (45.5%) of patients categorized as “IPV sacrifice” versus 132/242 (54.5%) categorized as “IPV preservation.” IPV diameter was observed to be <0.5 mm in 58 cases (23.9%), 0.5 mm–1.0 mm (≥0.5 mm and ≤1.0 mm) in 145 cases (59.9%), and >1 mm in 39 cases (16.2%). The position of IPV drainage into the jugular bulb was at the level of the accessory nerve in 163 cases (67.3%), the level of the vagus nerve in 42 cases (17.4%), and the level of the glossopharyngeal nerve or above in 37 cases (15.3%). The diameters of IPV in the sacrifice group were mainly less than 1 mm (94.5% vs. 75%, P < 0.01), and the cases with draining points near the glossopharyngeal nerve were more than that in the preservation group (27.3% vs. 5.3%, P < 0.01).ConclusionIPV is an obstructive structure in MVD for HFS, with considerable variations in diameters and draining points. IPV near the glossopharyngeal nerve significantly impacts surgical exposure and is often sacrificed for a better view of the operation field. Meanwhile, it is feasible to maintain IPVs with a diameter >1 mm.

show abstract

Section: Perspectives On Ipv Diametermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%