Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy

Abstract The vertebral artery (VA)-involved hemifacial spasm (HFS) has distinctive clinical features and performing microvascular decompression (MVD) is challenging. We described the clinical presentations of VA-involved HFS and the outcomes of MVD using the interposition method. Between January 200...

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Autores principales:	Seunghoon Lee, Junghoon Han, Sang-Ku Park, Jeong-A. Lee, Byung-Euk Joo, Kwan Park
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/020c2ce22b014db78da508c0471ca4a1
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spelling	oai:doaj.org-article:020c2ce22b014db78da508c0471ca4a12021-12-02T13:35:03ZInvolvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy10.1038/s41598-021-84347-x2045-2322https://doaj.org/article/020c2ce22b014db78da508c0471ca4a12021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84347-xhttps://doaj.org/toc/2045-2322Abstract The vertebral artery (VA)-involved hemifacial spasm (HFS) has distinctive clinical features and performing microvascular decompression (MVD) is challenging. We described the clinical presentations of VA-involved HFS and the outcomes of MVD using the interposition method. Between January 2008 and March 2015, MVD was performed in 271 patients with VA-involved HFS. Demographic characteristics, preoperative severity, intraoperative findings, spasm-free outcome, and complications were retrospectively evaluated. A control group of 1500 consecutive patients with non-VA-involved HFS was enrolled. VA-involved HFS was associated with older age (p < 0.001), less female predominance (p < 0.001), more left-sided predominance (p < 0.001), and rapid symptom progression before MVD (p < 0.001). The Teflon Fulcrum method allowed intraoperative identification of the neurovascular compression site in 92.6% of the cases, and showed more severe indentation on the facial nerve (p < 0.001). Changes in the brainstem auditory evoked potentials during MVD (p < 0.001) and postoperative non-serviceable hearing loss (p < 0.001) were more frequent in patients with VA-involved than in non-VA-involved HFS. The spasm-free outcome and overall complication rates after MVD were not significantly different between the groups. VA-involved HFS has distinctive clinical features and poses a major surgical challenge for MVD success. The interposition method is a feasible surgical strategy in VA-involved HFS.Seunghoon LeeJunghoon HanSang-Ku ParkJeong-A. LeeByung-Euk JooKwan ParkNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Seunghoon Lee Junghoon Han Sang-Ku Park Jeong-A. Lee Byung-Euk Joo Kwan Park Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy
description	Abstract The vertebral artery (VA)-involved hemifacial spasm (HFS) has distinctive clinical features and performing microvascular decompression (MVD) is challenging. We described the clinical presentations of VA-involved HFS and the outcomes of MVD using the interposition method. Between January 2008 and March 2015, MVD was performed in 271 patients with VA-involved HFS. Demographic characteristics, preoperative severity, intraoperative findings, spasm-free outcome, and complications were retrospectively evaluated. A control group of 1500 consecutive patients with non-VA-involved HFS was enrolled. VA-involved HFS was associated with older age (p < 0.001), less female predominance (p < 0.001), more left-sided predominance (p < 0.001), and rapid symptom progression before MVD (p < 0.001). The Teflon Fulcrum method allowed intraoperative identification of the neurovascular compression site in 92.6% of the cases, and showed more severe indentation on the facial nerve (p < 0.001). Changes in the brainstem auditory evoked potentials during MVD (p < 0.001) and postoperative non-serviceable hearing loss (p < 0.001) were more frequent in patients with VA-involved than in non-VA-involved HFS. The spasm-free outcome and overall complication rates after MVD were not significantly different between the groups. VA-involved HFS has distinctive clinical features and poses a major surgical challenge for MVD success. The interposition method is a feasible surgical strategy in VA-involved HFS.
format	article
author	Seunghoon Lee Junghoon Han Sang-Ku Park Jeong-A. Lee Byung-Euk Joo Kwan Park
author_facet	Seunghoon Lee Junghoon Han Sang-Ku Park Jeong-A. Lee Byung-Euk Joo Kwan Park
author_sort	Seunghoon Lee
title	Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy
title_short	Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy
title_full	Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy
title_fullStr	Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy
title_full_unstemmed	Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy
title_sort	involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/020c2ce22b014db78da508c0471ca4a1
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Involvement of the vertebral artery in hemifacial spasm: clinical features and surgical strategy

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