• Hua Zhao, Guang-Feng Li, Xin Zhang, Yin-da Tang, Ping Zhou, Jin Zhu, and Shi-Ting Li.
• Department of Neurosurgery, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
• World Neurosurg. 2018 Jan 1; 109: e778-e782.

ObjectiveHemifacial spasm (HFS) is a disorder characterized by intermittent, involuntary facial muscle contractions. Microvascular decompression (MVD) is the gold treatment for HFS. The aim of this research was to discuss whether patients undergoing MVD as their initial surgical intervention experience greater spasm control than patients experiencing an MVD performed as a subsequent surgical intervention.MethodsThe study included 976 patients with HFS, 452 of whom (group A) underwent MVD as their initial surgical intervention and 524 of whom (group B) underwent subsequent MVD. Relevant clinical data including outcome of MVD, operative findings, complications, and so on were collected immediately after MVD operation and at follow-up.ResultsThe follow-up period was 7-9 years (mean, 7.96 ± 0.87 years). The mean age at intervention was 53.14 years and 55.43 years in the 2 groups, respectively. The long-term postoperative relief rate of patients in the 2 groups was 98.23% and 87.21%, respectively. There was a significant difference in long-term postoperative relief rate of patients between the 2 groups (P < 0.05).ConclusionsPatients undergoing MVD for HFS as the primary treatment experience better long-term efficacy than patients first treated with botulinum neurotoxin type A.Copyright © 2017 Elsevier Inc. All rights reserved.

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