SURGICAL OUTCOME OF MICROVASCULAR DECOMPRESSION FOR HEMIFACIAL SPASM

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Sajjad Ahmad
Farooq Azam
Noor Ul Hussain
Mumtaz Ali

Abstract

Objective: To determine the surgical outcome of Microvascular decompression for hemifacial spasm in terms of
symptomatic improvement.
Material & Methods: This Prospective observational study was conducted at the department of Neurosurgery, Lady
Reading Hospital Peshawar, from July, 2014 to June, 2017. A total of 10 patients who underwent Microvascular decompression
for hemifacial spasm and fulfilled the inclusion criteria were included in the study. Strict exclusion criteria were
followed to avoid bias in the study. Per-operative findings were noted. Post-operatively the patients were examined for
symptomatic improvement at the time of discharge and at 6 months follow up. The results were assessed with hemifacial
spasm outcome scale. Any post-op complications were noted. SPSS version 22 was used for statistical analysis.
Results: Out of total 10 patients, 6 (60%) were females and 4 (40%) were males. The mean age was 42.80 ±9.06
years, with a range of 28-55 years. The duration of preoperative symptoms ranged from 2 to 7 years with a mean of
3.9 years. Right side was involved in half (50%) of the cases. Per-operatively, the offending vessel was anterior inferior
cerebellar artery (AICA) in 7 patients. Post-operatively 6 patients (60%) had excellent, 2(20%) patients had good and
2(20%) patients had poor outcome. At 6month follow up 8 (80%) patients had excellent, 1 (10%) patient had good and
1 (10%) patient had poor outcome. Post-operatively 2 (20%) patients developed hearing loss and one (10%) patient
developed facial nerve palsy. At 6 months follow up only one (10%) patient had persistent hearing loss, while the other
two patients improved clinically.
Conclusion: Microvascular decompression is an effective procedure for hemifacial spasm with acceptable rate of
complications.

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