Microvascular Decompression of the Facial Nerve for the Treatment of Hemifacial Spasm: Preoperative Magnetic Resonance Imaging Related to Clinical Outcomes

Chung, Sang Sup; Chang, Jin Woo; Kim, S. H.; Chang, Jinwoo; Park, Y. G.; Kim, D. I.

doi:10.1007/s007010070076

Cited by 52 publications

(25 citation statements)

References 19 publications

(30 reference statements)

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“…A positive correlation between the presence of a vascular indentation at the root exit zone and a good outcome after MVD for HFS [42] has been known for some time and an intraoperative finding of a root exit zone indentation has been described as a favorable prognostic factor [42,43] . Our success rate of 90%, determined by complete resolution of symptoms, compares favorably with the reported success rates of 82-92% in some recent series [9,42,[44][45][46] . There are conflicting data regarding time taken for resolution of symptoms and preservation of the effects of surgery.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcome and Improvement in Quality of Life after Microvascular Decompression for Hemifacial Spasms: A Case Series Assessment Using a Validated Disease-Specific Scale

Ray

Bahgat

McCartney

et al. 2010

Stereotact Funct Neurosurg

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Background: Hemifacial spasm (HFS) is a movement disorder characterized by intermittent, involuntary clonic or tonic-clonic contractions of muscles innervated by the ipsilateral facial nerve. Recent studies have documented change in quality of life after HFS management with botulinum toxin injection. However, we failed to locate any study that documented change in quality of life after surgical management with retrosigmoid microvascular decompression (MVD). Methods: Our study objectives were 3-fold. Firstly, to use a disease-specific, validated quality of life assessment scale to document any change in quality of life after MVD for HFS. Secondly, to determine the time period in which the majority of patients undergoing MVD could be expected to benefit from surgery. Finally, to determine factors affecting the postoperative quality of life following MVD. A retrospective analysis of HFS patients treated with MVD at a single institution by a single surgeon (K.J.B.) between January 2000 and December 2007 was undertaken. A modification of a previously developed validated disease-specific quality of life assessment scale that included the addition of a parameter for difficulty in sleep was used to assess quality of life before and after surgery. Results: A total of 21 patients (14 female and 7 male) underwent treatment as specified. Eighty-five percent (17/20) of the patients reported prolonged remission of symptoms (mean follow-up period = 4.15 years). Five percent (1/20) reported occasional recurrence of twitches. The overall mean quality of life score improved from 11.1 preoperatively to 2.2 postoperatively. Conclusions: MVD offers significant and prolonged improvement in quality of life for the HFS patients we studied, as measured using a disease-specific, validated quality of life assessment scale. Postoperative quality of life, however, was strongly influenced by both the success of surgery in resolving the symptoms and the absence of any permanent complications of surgery.

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Section: Discussionmentioning

confidence: 99%

Surgical Outcome and Improvement in Quality of Life after Microvascular Decompression for Hemifacial Spasms: A Case Series Assessment Using a Validated Disease-Specific Scale

Ray

Bahgat

McCartney

et al. 2010

Stereotact Funct Neurosurg

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“…Chung et al proposed three-dimensional time of flight magnetic resonance angiography (3D-TOF-MRA) for hemifacial spasm preoperatively [20]. According to some reports 3D-TOF-MRA has proved to be the method of choice for investigating the CP angle for neurovascular relationships in patients with hemifacial spasm and trigeminal neuralgia [21 ± 24].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Anterior Inferior Cerebellar Artery and Facial-Vestibulocochlear Nerve Complex: An Anatomical and Magnetic Resonance Images Correlation Study

Yurtseven¹,

Savaş²,

Koçak³

et al. 2004

Minim Invasive Neurosurg

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For the successful microneurosurgical treatment of CP angle located pathologies, an understanding of the relationship and variations between neural and vascular structures and a certain diagnosis are the most valuable factors for surgeons. CP angle lesions have now become a visible area by advances in magnetic resonance imaging (MRI) technology. An evaluation of this area and the decision for a neurosurgical decompression procedure are easier than before. Twenty unfixed adult human cadaver specimens, that have no sign of central nervous system pathology, were obtained and dissected bilaterally at routine autopsy. The facial-vestibulocochlear (VII - VIIIth) nerve complex and the anterior inferior cerebellar artery (AICA) were identified in all specimens. Thirteen of the 40 (32.5 %) AICA were situated ventrally and fourteen (35 %) were located dorsally to the VII - VIIIth nerve complex. Thirteen (32.5 %) passed between the VIIth and the VIIIth nerve fibers. Five of the 40 (12.5 %) AICA had a loop near the nerve complex and then passed the nerves ventrally or dorsally. In an MRI study 74 adult persons (148 sides) were investigated by using three-dimensional Fourier transformation constructive interference in the steady state technique (3D FT-CISS) on a 1.5 Tesla MRI system (Siemens Magnetom, Erlangen, Germany). The results were as follows; 48 AICA (32.4 % of all 148 AICA) were situated ventrally to the VII-VIIIth nerve complex, 45 AICA (30.4 %) were situated dorsally to the VII-VIIIth nerve complex, and the AICA passed between the VIIth and VIIIth nerves in 51 samples (34.5 %). In four of the 148 CP angles (2.7 %), the AICA was not identified. There was an AICA loop coursing to the internal acoustic meatus in 15 patients (10.1 %). In this study, we examined the relations between VIIth and VIIIth nerve complex and the AICA in cadaver and MRI materials for an understanding of the value and reliability of the radiological data. This study also shows the anatomical variation between these structures.

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“…Neurovascular compression can be localized in the following four anatomical portions of the facial nerve: root exit point (RExP), attached segment (AS), root detachment (RDP), the point corresponding to the transitional zone, and the distal cisternal portion (CP) 4 . The severity of compression has been defined as follows: mild if there is contact without nerve indentation; moderate if facial nerve indentation is present; and severe in the case of an eventual deviation of the nerve course 11 . Vascular compression of the facial nerve root found.…”

Section: Discussionmentioning

confidence: 99%

Developmental Venous Anomaly Responsible for Hemifacial Spasm

et al. 2013

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Microvascular Decompression of the Facial Nerve for the Treatment of Hemifacial Spasm: Preoperative Magnetic Resonance Imaging Related to Clinical Outcomes

Cited by 52 publications

References 19 publications

Surgical Outcome and Improvement in Quality of Life after Microvascular Decompression for Hemifacial Spasms: A Case Series Assessment Using a Validated Disease-Specific Scale

Surgical Outcome and Improvement in Quality of Life after Microvascular Decompression for Hemifacial Spasms: A Case Series Assessment Using a Validated Disease-Specific Scale

Relationship between Anterior Inferior Cerebellar Artery and Facial-Vestibulocochlear Nerve Complex: An Anatomical and Magnetic Resonance Images Correlation Study

Developmental Venous Anomaly Responsible for Hemifacial Spasm

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