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Abstract

Three hundred patients with idiopathic hemifacial spasm who underwent microvascular decompression through the retrosigmoid approach are reported. Vascular compression was found in every patient on operation. The results of 1 to 6 years of follow-up show that 276 patients are free of the symptom, 4 patients have markedly diminished spasms and a decreased episode rate, 10 patients have no significant relief from the operation, and 9 have had recurrences of the symptom since the operation. The cure rate in this group is 92%. Complications were sensorineural hearing loss in 13 patients (7 temporary cases, 6 permanent), tinnitus in 7 (4 temporary cases, 3 permanent), temporary postoperative facial weakness in 16, and postoperative meningitis in 10 (9 cases were controlled with antibiotics and 1 patient died).

Keywords

hemifacial spasm microvascular decompression retrosigmoid approach

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References

Jannetta

Abbasy

Maroon

. Etiology and definitive microsurgical treatment of hemifacial spasm. Operative techniques and results in 47 patients. J Neurosurg 1977;47: 321–8.

Rand

. Gardner neurovascular decompression of the trigeminal and facial nerves for tic douloureux and hemifacial spasm. Surg Neurol 1981;16: 329–32.

Wilson

. Microsurgical vascular decompression for trigeminal neuralgia and hemifacial spasm. West J Med 1980;132: 481–4.

Fukushima

. Facial spasm and trigeminal neuralgia with operation of Jannetta. Operation 1983;37: 1311–5.

Alksne

. Microsurgical vascular decompression of cranial nerves. Am J Surg 1980;140: 156–7.

Adams

CBT

. Microvascular compression: an alternative view and hypothesis. J Neurosurg 1989;57: 1–12.

Adams

CBT

Kaye

. Hemifacial spasm: treatment by posterior fossa surgery. J Neurol Neurosurg Psychiatry 1983;46: 465–6.

Ludman

Choa

. Hemifacial spasm: operative treatment. J Laryngol Otol 1985;99: 239–45.

Jannetta

. Observation on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction, and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients. Neurochirurgia (Stuttg) 1977;20: 145–54.

10.

Zhang

Shun

Zhao

. Vascular loop compression of seventh and eighth cranial nerves. Pakistan J Otolaryngol 1988;4: 85–8.

11.

Hughes

Hahn

. Surgery for vertigo. Am J Otol 1985;6: 423–8.

12.

Zhang

Shun

Zhao

. Microvascular decompression by retrosigmoid approach for trigeminal neuralgia: experience in 200 patients. Ann Otol Rhinol Laryngol 1990;99: 129–30.

13.

Zhang

Shun

. Neurovascular decompression by retrosigmoid craniotomy for trigeminal neuralgia and hemifacial spasm. Pakistan J Otolaryngol 1987;3: 49–52.

14.

Han

Fan

. Microanatomical relationships of the anterior inferior cerebellar artery and the facial nerve. Chin J Otorhinolaryngol 1990;25: 133–4.

15.

Zhou

Fang

Yang

Tao

. Blood vessels in the pontocerebellar space and internal auditory meatus (a microsurgical and anatomical study). Chin J Otorhinolaryngol 1984;19: 106–8.

16.

Lei

Han

Huang

Hao

Lü

. The arterial relation, the blood supply of the facial and the vestibulocochlear nerves at the pontocerebellar angle and the internal acoustic meatus. Chin J Anat 1987;10: 222–6.

17.

Jannetta

. Hemifacial spasm. In: Samii

Jannetta

, eds. The cranial nerves: anatomy, pathology, pathophysiology, diagnosis, treatment. Berlin, Germany: Springer-Verlag, 1981: 484–93.

18.

Zhang

. Resection of tumor of the cerebellopontine angle by the retrosigmoid approach. Chin J Otorhinolaryngol 1993;28: 76.

19.

Moller

Jannetta

. Monitoring facial EMG responses during microvascular decompression operation for hemifacial spasm. J Neurosurg 1987;66: 681–5.

Microvascular Decompression by the Retrosigmoid Approach for Idiopathic Hemifacial Spasm: Experience with 300 Cases

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