Operative Complications of Microvascular Decompression for Hemifacial Spasm: Experience of 1548 Cases

World Neurosurg. 2017 Nov:107:559-564. doi: 10.1016/j.wneu.2017.08.028. Epub 2017 Aug 18.

Abstract

Background: Although microvascular decompression (MVD) surgery is considered the gold standard treatment for hemifacial spasm, there are some MVD-related complications.

Methods: We retrospectively reviewed 1548 patients with hemifacial spasm who underwent retromastoid suboccipital craniectomy with MVD from January 2009 to June 2013. All patients were followed for >2 years.

Results: Excellent and good results were 92.5% and 4.2%, respectively. Postoperative complications were recorded in 16.09% (n = 249). There was no MVD-related mortality. After MVD surgery, the most frequent complications were occipital sensory disturbance (7.3%), facial nerve palsy (9.7%), and hearing impairment (3.5%). Other complications were as follows: cerebrospinal fluid leakage (n = 24), poor healing wound (n = 14), lower cranial nerve palsy (n = 12), wound infection (n = 4), and hemorrhage (n = 2).

Conclusions: MVD operation is a safe treatment for hemifacial spasm. Facial nerve palsy is the most common MVD-related complication; preservation of the lesser occipital nerve during MVD surgery can decrease the rate of occipital sensory disturbance. Permanent or serious complications are comparatively rare in MVD surgery.

Keywords: Complications; Hemifacial spasm; Microvascular decompression.

MeSH terms

  • Adult
  • Aged
  • Cerebrospinal Fluid Leak / etiology
  • Cranial Nerve Diseases / etiology
  • Craniotomy / methods
  • Female
  • Hearing Loss / etiology
  • Hemifacial Spasm / surgery*
  • Humans
  • Male
  • Microvascular Decompression Surgery / adverse effects*
  • Middle Aged
  • Postoperative Complications / etiology
  • Sensation Disorders / etiology
  • Surgical Wound Infection / etiology