• Yoshifumi Mizobuchi, Shinji Nagahiro, Akinori Kondo, Kazunori Arita, Isao Date, Yukihiko Fujii, Takamitsu Fujimaki, Ryosuke Hanaya, Mitsuhiro Hasegawa, Toru Hatayama, Kazuhiro Hongo, Tooru Inoue, Hidetoshi Kasuya, Masahito Kobayashi, Eiji Kohmura, Toshio Matsushima, Jun Masuoka, Akio Morita, Shigeru Munemoto, Shigeru Nishizawa, Yoshihiro Okayama, Kimitoshi Sato, Taku Shigeno, Hiroshi Shimano, Hideo Takeshima, Hideki Tanabe, and Iwao Yamakami.
• Department of Neurosurgery, Tokushima University Faculty of Medicine, Tokushima, Japan.
• Neurosurgery. 2021 Mar 15; 88 (4): 846-854.

BackgroundMicrovascular decompression (MVD) is the most effective procedure for hemifacial spasm (HFS). MVD results from nonspecialized or low-volume institutes are not always reliable. Most studies on MVD for HFS are retrospective and single centered; to the best of our knowledge, no prospective, multicenter studies exist.ObjectiveTo evaluate short- and long-term outcomes and complications in patients who underwent MVD for HFS in specialized Japanese institutions, in this multicenter, prospective, cohort study.MethodsIncluded patients had undergone MVD for HFS in study centers between April 2012 and March 2015. Patients' postoperative grade of involuntary movements and complications were recorded postoperatively at 7 d (short-term) and at 1 (mid-term) and 3 (long-term) yr.ResultsA total of 486 patients (150 men, 336 women; mean age 53.9 yr with 181 patients over 60 yr) were enrolled during the study period. Neuromonitoring was used in 96.3% of the cases. The complete cure rate of symptom relief, mortality rate, and complication rate at short-term follow-up were 70.6%, 0%, and 15%, respectively. The long-term follow-up was completed by 463 patients (95.3%); the complete cure rate of symptom relief and complication rate were 87.1% and 3.0%, respectively.ConclusionOur study revealed that under expert guidance and intraoperative neuromonitoring, the long-term curative effect rate of MVD for HFS is high, while complications are uncommon and usually transient. Our results indicate that MVD is an effective and safe treatment for patients with HFS, including elderly patients.© Congress of Neurological Surgeons 2021.

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