Prognosis research of delayed facial palsy after microvascular decompression for hemifacial spasm

被引:15
作者
Liu, Lun-Xin [1 ]
Zhang, Chang-Wei [1 ]
Ren, Peng-Wei [1 ]
Xiang, Shou-Wei [1 ]
Xu, Ding [1 ]
Xie, Xiao-Dong [1 ]
Zhang, Heng [1 ]
机构
[1] Sichuan Univ, Dept Neurosurg, West China Hosp, Add 37 Guo Xue Xiang, Chengdu 610041, Sichuan, Peoples R China
关键词
Hemifacial spasm; Microvascular decompression; Delayed facial palsy; Hypertension; Risk/predisposing factors; REACTIVATION; VIRUS;
D O I
10.1007/s00701-015-2652-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Although microvascular decompression (MVD) surgery has been widely accepted as an effective treatment for hemifacial spasm (HFS), delayed facial palsy (DFP) is not an unusual complication, but it has only been sporadically described in the literature. The purpose of this study was to examine the probability of occurrence, the risk/predisposing factors, and the prognosis and timing of DFP. A prospective cohort study was conducted that included patients diagnosed with HFS and treated by MVD at our institution. All patients were followed up at the outpatient department or by telephone from December 2009 to December 2014. Categorical variables were analyzed using the Pearson's Chi-square test or Fisher's exact test. Continuous variables were compared using the independent Student's t test. The Spearman rank test was used to determine the correlation between the time of onset and the duration of DFP. The risk/predisposing factors were analyzed by the logistic regression method. We enrolled 248 patients who were treated by MVD for HFS. During the follow-up period, 16 patients (6.5 %) developed DFP. Fifteen of those patients had a complete recovery, and in one patient the facial palsy did not resolve. The average onset time was 10.2 days (range, 2-30 days) after surgery, and the mean duration of DFP after MVD, with exclusion of the permanent facial palsy patient, was 59.7 days (range, 7-220 days). The time of onset was correlated with the duration of DFP after MVD (p = 0.036). Furthermore, hypertension contributed to DFP (odds ratio [OR] 4.226, 95 % confidence interval [CI] 1.089-16.401, p = 0.037). Although the degree of facial palsy was variable, most patients experienced a complete recovery without requiring any special treatment. DFP may be a self-healing disease that resolves spontaneously without any treatment. The time of onset was correlated with the duration of DFP; i.e., an earlier development of DFP corresponded with a shorter duration, whereas a later development of DFP corresponded with a longer duration. Our results also suggest that hypertension contributes to DFP.
引用
收藏
页码:379 / 385
页数:7
相关论文
共 22 条
[1]  
BADEMOSI O, 1987, African Journal of Medicine and Medical Sciences, V16, P197
[2]   MICROVASCULAR DECOMPRESSION FOR HEMIFACIAL SPASM [J].
BARKER, FG ;
JANNETTA, PJ ;
BISSONETTE, DJ ;
SHIELDS, PT ;
LARKINS, MV ;
JHO, HD .
JOURNAL OF NEUROSURGERY, 1995, 82 (02) :201-210
[3]   Delayed facial paralysis after vestibular schwannoma surgery: Role of herpes viruses reactivation - Our experience in eight cases [J].
Franco-Vidal, V ;
Nguyen, DQ ;
Guerin, T ;
Darrouzet, V .
OTOLOGY & NEUROTOLOGY, 2004, 25 (05) :805-810
[4]  
Furukawa K, 2003, NEUROL SURG TOKYO, V31, P899
[5]  
Gianoli GJ, 1996, AM J OTOL, V17, P625
[6]   Delayed Cranial Nerve Palsy after Microvascular Decompression for Hemifacial Spasm [J].
Han, Jae-Suk ;
Lee, Jeong-Ah ;
Kong, Doo-Sik ;
Park, Kwan .
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, 2012, 52 (04) :288-292
[7]   Delayed cranial neuropathy after neurosurgery caused by herpes simplex virus reactivation: report of three cases [J].
Hengstman, GJD ;
Gons, RAR ;
Menovsky, T ;
Lunel, FV ;
van de Vlasakker, CJW ;
de Vries, J .
SURGICAL NEUROLOGY, 2005, 64 (01) :67-70
[8]   Microvascular decompression for hemifacial spasm: analyses of operative complications in 1582 consecutive patients [J].
Huh, Ryoong ;
Han, In Bo ;
Moon, Ji Young ;
Chang, Jin Woo ;
Chung, Sang Sup .
SURGICAL NEUROLOGY, 2008, 69 (02) :153-157
[9]   Microvascular decompression for treating hemifacial spasm: lessons learned from a prospective study of 1,174 operations [J].
Hyun, Seung-Jae ;
Kong, Doo-Sik ;
Park, Kwan .
NEUROSURGICAL REVIEW, 2010, 33 (03) :325-334
[10]  
Jannetta PJ, 1998, J NEUROSURG, V89, P346