Microvascular decompression in patients aged 30 years or younger

Karki, Prasanna; Yamagami, Masayuki; Takasaki, Koji; Bohara, Manoj; Hosoyama, Hiroshi; Hanada, Tomoko; Yamasaki, Fumiyuki; Hanaya, Ryosuke; Arita, Kazunori

doi:10.4103/ajns.ajns_266_17

Cited by 7 publications

(3 citation statements)

References 35 publications

(76 reference statements)

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“…Female predominance was found in three published studies and in our study (male-to-female ratio, 1:1.5). However, Jho and Jannetta [7] showed an equal maleto-female ratio, and Karki et al [13] showed male predominance. Their studies had small patient groups of 10 and 6, respectively.…”

Section: Discussionmentioning

confidence: 95%

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Clinical characteristics of patients with young-onset hemifacial spasm: a retrospective analysis of 151 cases

Jung¹,

Park²,

Park³

2021

J Korean Ster Func Neurosurg

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The average age of hemifacial spasm (HFS) onset is mostly between the fifth and sixth decades of life, with a relatively low incidence in younger age groups. The objective of this study was to analyze the characteristics and clinical outcomes of young-onset hemifacial spasm (YOHFS).Methods: Between April 1997 and March 2021, 151 HFS patients aged 30 years or younger at the time of microvascular decompression (MVD) were selected. We analyzed their epidemiological characteristics, intraoperative findings, improvements, and postoperative complications by reviewing medical records.Results: This study included 151 patients who underwent MVD. The average age of the patients was 26 years. The mean symptom duration was 36.5 months. The male-to-female sex ratio was 1:1.5. The most common offending vessel was the anterior inferior cerebellar artery, and the most common compression type was the arachnoid type. Improvements in spasm after MVD were seen in 96.7% of patients. No permanent facial palsy was noted after MVD. Changes in brainstem auditory-evoked potentials were recorded in 11 patients; however, no permanent hearing loss was observed. Conclusion:The characteristics and clinical outcomes of YOHFS in this study were similar to those of patients with HFS in the general population. Based on the clinical outcomes, MVD for YOHFS is effective and safe. Therefore, MVD should be considered in patients with YOHFS.

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Section: Discussionmentioning

confidence: 95%

“…We find five previous studies in the literature of patients with YOHFS who underwent MVD in PubMed search [7,8,[12][13][14]. Two studies included 10 or less than 10 patients and largest cohort reported by Chang et al [8] included 33 patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of patients with young-onset hemifacial spasm: a retrospective analysis of 151 cases

Jung¹,

Park²,

Park³

2021

J Korean Ster Func Neurosurg

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“…4 A variety of treatment options are available for the management of pain for TN patients, such as anti-epileptic drugs, radiofrequency thermocoagulation, chemical (alcohol and glycerol) injections, microvascular decompression (MVD), gamma knife radiosurgery (GKRS) and percutaneous balloon compression (PBC). [5][6][7][8][9][10][11][12] However, each of these therapies has its own unique disadvantage. Long-term use of anti-epileptic drugs can cause various side effects, such as dizziness, nausea and vomiting.…”

Section: Introductionmentioning

confidence: 99%

<p>Efficacy and Safety of Percutaneous Ozone Injection Around Gasserian Ganglion for the Treatment of Trigeminal Neuralgia: A Multicenter Retrospective Study</p>

Gao¹,

Chen²,

Williams³

et al. 2020

JPR

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Background: Ozone injection around Gasserian ganglion (OIAGG) has been reported to be an effective treatment for trigeminal neuralgia (TN); however, there remain areas for improvement. To overcome one of these limitations, a multicenter examination of application would be extremely helpful. Objective: The goal of this report was to assess the efficacy of OIAGG for refractory TN across multiple centers and to explore factors predictive of successful treatment. Design: A multicenter, retrospective study. Setting: The study was conducted across 3 pain centers across China. Patients and Methods: A total of 103 subjects from 3 pain centers were enrolled in the study. An ozone-oxygen mixture gas at a concentration of 30 µg/mL was injected into the area around the Gasserian ganglion performed under C-arm X-ray guidance. Primary outcome measures included a pain assessment using a visual analog scale (VAS) and the Barrow Neurological Institute (BNI) pain intensity scale. Clinical assessment of patients for these outcome measures was performed at pretreatment, post-treatment, 6 months, 1 year and 2 years after the OIAGG. Results: Successful pain relief was defined as a score within BNI grades I-IIIa. The pain relief rates at post-treatment, 6 months, 1 year and 2 years after the procedure were 88.35%, 86.87%, 84.46% and 83.30%, respectively. The VAS at each observation time point was significantly different from the preoperative levels (P<0.05). Logistic regression analysis showed that previous nerve damage had a significant effect on the treatment results. No significant complications or side effects were found during or after treatment. Conclusion: This multicenter research confirms our previous single center results that OIAGG is both effective and safe for patients with TN.

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A New Application of Gelatin Sponge in the Treatment of Hemifacial Spasm by Microvascular Decompression: A Technical Note

Chang

Tang

Wei

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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Objectives Microvascular decompression (MVD) for facial nerve remains the highly efficient hemifacial spasm (HFS) treatment. Nonetheless, a variety of cases have poor response to MVD. Using Teflon plus gelatin sponge in MVD seems to be a good solution. No existing study has examined the efficacy of using Teflon combined with gelatin sponge during MVD for HFS. Therefore, this study aimed to compare the efficacy of Teflon combined with gelatin sponge in HFS patients relative to that of Teflon alone. Patients and Methods We retrospectively compared the follow-up results of patients treated with Teflon and gelatin sponge with those treated with Teflon alone previously. Six hundred and eighty-eight primary HFS patients undergoing surgery from January 2010 to January 2018 were retrospectively analyzed. Three hundred and forty-seven cases received simple Teflon, while 342 cases underwent Teflon combined with gelatin sponge. Results In the Teflon plus gelatin sponge group, the incidences of facial palsy and hearing loss at 1 day, 1 year, and 2 years following surgery was significantly lower than those in the simple Teflon group. Differences in the success rates between Teflon plus gelatin sponge and the simple Teflon group were not statistically significant at 1 day, 1 year, and 2 years after surgery. The recurrence rate in the Teflon plus gelatin sponge group was significantly lower at 2 years. Conclusion For HFS patients undergoing MVD, using Teflon plus gelatin sponge can remarkably reduce the incidence of recurrence, facial palsy, and hearing loss compared with those using Teflon alone.

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Microvascular decompression in patients aged 30 years or younger

Cited by 7 publications

References 35 publications

Clinical characteristics of patients with young-onset hemifacial spasm: a retrospective analysis of 151 cases

Clinical characteristics of patients with young-onset hemifacial spasm: a retrospective analysis of 151 cases

<p>Efficacy and Safety of Percutaneous Ozone Injection Around Gasserian Ganglion for the Treatment of Trigeminal Neuralgia: A Multicenter Retrospective Study</p>

A New Application of Gelatin Sponge in the Treatment of Hemifacial Spasm by Microvascular Decompression: A Technical Note

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