• Hua Zhao, Xin Zhang, Yin-da Tang, Ying Zhang, Ting-Ting Ying, Jin Zhu, and Shi-Ting Li.
• Department of Neurosurgery, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
• World Neurosurg. 2017 Nov 1; 107: 559-564.

BackgroundAlthough microvascular decompression (MVD) surgery is considered the gold standard treatment for hemifacial spasm, there are some MVD-related complications.MethodsWe 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.ResultsExcellent 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).ConclusionsMVD 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.Copyright © 2017. Published by Elsevier Inc.

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