Short-term versus long-term outcomes of microvascular decompression for hemifacial spasm

This paper evaluates the outcome of retrosigmoid microvascular decompression of the facial nerve in a series of patients suffering from hemifacial spasm who had been referred to the skull-base team (comprising senior authors DAM and DGH). The paper is a retrospective review of 15 patients who underwent retrosigmoid microvascular decompression of the facial nerve at Addenbrooke's Hospital between 1985 and 1995. In this series it was possible to obtain complete resolution of hemifacial spasm in 93.3 per cent of cases in the short term and in 80 per cent in the long term. Twelve patients (80 per cent) were symptom-free post-operatively. Two patients had minor recurrence of symptoms occurring within six months of the procedure. One patient with no identifiable vascular impingement of the facial nerve had no improvement following surgery. Three patients suffered sensorineural hearing loss. Two patients complained of post-operative tinnitus, and transient facial palsy was noted in one patient.Retrosigmoid microvascular decompression of the facial nerve provides excellent long-term symptom control in a high percentage of patients with hemifacial spasm.

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Long-term Outcomes of Microvascular Decompression in the Treatment of Hemifacial Spasm Based on Different Offending Vessels

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0039-1685199 ◽

2019 ◽

Vol 80 (04) ◽

pp. 285-290 ◽

Cited By ~ 2

Author(s):

Hua Zhao ◽

Yinda Tang ◽

Xin Zhang ◽

Jin Zhu ◽

Yan Yuan ◽

...

Keyword(s):

Hemifacial Spasm ◽

Microvascular Decompression ◽

Posterior Inferior Cerebellar Artery ◽

Study Groups ◽

Effective Rate ◽

Anterior Inferior Cerebellar Artery ◽

Long Term Outcomes ◽

Root Exit Zone ◽

Cerebellar Artery

Objective To evaluate clinical features, outcomes, and complications in patients with hemifacial spasm (HFS) after microvascular decompression (MVD) of different offending vessels. Methods Clinical data were collected from 362 patients with HFS treated with MVD between January 2013 and January 2014. Patients were divided into five groups based on the offending vessel: A (anterior inferior cerebellar artery [AICA] compression), B (posterior inferior cerebellar artery [PICA] compression), C (AICA plus PICA compression), D (vertebral artery [VA] compression), and E (VA plus small vessel compression). Results The most common offending vessel was the AICA (51.38%). The most common compression site was the root exit zone. During the follow-up period, the effective rate was 95.48% in group A, 92.15% in group B, 93.10% in group C, 90.14% in group D, and 91.45% in group E. Twenty-nine patients exhibited delayed facial palsy, the most common complication. Conclusion No statistically significant differences were found in long-term outcomes or MVD-related complications among the study groups. The type of offending vessel was not a prognostic factor for MVD in patients with HFS.

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Prognostic value of lateral spread response during microvascular decompression for hemifacial spasm

Journal of International Medical Research ◽

10.1177/0300060519839526 ◽

2019 ◽

Vol 47 (12) ◽

pp. 6120-6128

Author(s):

Hongmei Song ◽

Songbai Xu ◽

Xiushuang Fan ◽

Mingxin Yu ◽

Jiachun Feng ◽

...

Keyword(s):

Hemifacial Spasm ◽

Microvascular Decompression ◽

Surgical Outcomes ◽

Prognostic Value ◽

Prognostic Indicator ◽

Lateral Spread ◽

Short Term ◽

Group A ◽

Lateral Spread Response

Objective This study aimed to investigate the prognostic value of the lateral spread response (LSR) for predicting surgical outcomes following microvascular decompression (MVD) in patients with hemifacial spasm. Methods Seventy-three patients with hemifacial spasm underwent MVD with intraoperative LSR monitoring. Surgical outcomes were evaluated 1 week and 1 year after MVD and correlations between LSR characteristics and surgical outcomes were analyzed. Results The LSR disappeared completely in 61 patients during surgery (Group A; prior to insertion of Teflon felt pledgets in 11, after insertion of pledgets in 50), disappeared partially in nine patients (Group B), and remained unchanged in three patients (Group C). Fifty-five patients showed short-term and 61 patients showed long-term clinical cures during the follow-up period. The short-term and long-term cure rates were significantly higher in Group A than in Group C. There was no correlation between the time of complete LSR disappearance and surgical outcomes. Conclusions Disappearance of the LSR during MVD is correlated with the surgical outcomes. Intraoperative LSR monitoring is a reliable approach for predicting the prognosis of hemifacial spasm following MVD, but the time at which LSR disappears is not a prognostic indicator.

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Abstract #238: Improved Short Term and Long Term Outcomes of Early Insulin Initiation in Type 2 Diabetes Over 10 Years

Endocrine Practice ◽

10.1016/s1530-891x(20)44358-7 ◽

2017 ◽

Vol 23 ◽

pp. 50

Author(s):

Jothydev Kesavadev ◽

Shashank Joshi ◽

Banshi Saboo ◽

Hemant Thacker ◽

Arun Shankar ◽

...

Keyword(s):

Type 2 Diabetes ◽

Insulin Initiation ◽

Long Term Outcomes ◽

Short Term

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Effect of Thrombocytopenia on Short-term and Long-term Outcomes after Esophagectomy for Esophageal Cancer

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.69.327 ◽

2018 ◽

Vol 69 (6) ◽

pp. 327-334

Author(s):

Takashi Matsumoto ◽

Naoya Yoshida ◽

Yoshifumi Baba ◽

Yohei Nagai ◽

Hideo Baba

Keyword(s):

Esophageal Cancer ◽

Long Term Outcomes ◽

Short Term

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Short-term and long-term outcomes in living donors for liver transplantation: Cohort study

International Journal of Surgery ◽

10.1016/j.ijsu.2020.11.013 ◽

2020 ◽

Vol 84 ◽

pp. 147-153

Author(s):

Kosei Takagi ◽

Yuzo Umeda ◽

Ryuichi Yoshida ◽

Nobuyuki Watanabe ◽

Takashi Kuise ◽

...

Keyword(s):

Liver Transplantation ◽

Cohort Study ◽

Living Donors ◽

Long Term Outcomes ◽

Short Term

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Robotic and laparoscopic liver surgery for colorectal liver metastases: an experience from a German Academic Center

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02113-1 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Mirhasan Rahimli ◽

Aristotelis Perrakis ◽

Vera Schellerer ◽

Andrew Gumbs ◽

Eric Lorenz ◽

...

Keyword(s):

Abdominal Surgery ◽

Minimally Invasive ◽

Liver Surgery ◽

Colorectal Liver Metastases ◽

Survival Rates ◽

Long Term Outcomes ◽

Short Term ◽

Minimally Invasive Liver Surgery ◽

Previous Abdominal Surgery

Abstract Background Minimally invasive liver surgery (MILS) in the treatment of colorectal liver metastases (CRLM) is increasing in incidence. The aim of this work was to present our experience by reporting short-term and long-term outcomes after MILS for CRLM with comparative analysis of laparoscopic (LLS) and robotic liver surgery (RLS). Methods Twenty-five patients with CRLM, who underwent MILS between May 2012 and March 2020, were selected from our retrospective registry of minimally invasive liver surgery (MD-MILS). Thirteen of these patients underwent LLS and 12 RLS. Short-term and long-term outcomes of both groups were analyzed. Results Operating time was significantly longer in the RLS vs. the LLS group (342.0 vs. 200.0 min; p = 0.004). There was no significant difference between the laparoscopic vs. the robotic group regarding length of postoperative stay (8.8 days), measured blood loss (430.4 ml), intraoperative blood transfusion, overall morbidity (20.0%), and liver surgery related morbidity (4%). The mean BMI was 27.3 (range from 19.2 to 44.8) kg/m2. The 30-day mortality was 0%. R0 resection was achieved in all patients (100.0%) in RLS vs. 10 patients (76.9%) in LLS. Major resections were carried out in 32.0% of the cases, and 84.0% of the patients showed intra-abdominal adhesions due to previous abdominal surgery. In 24.0% of cases, the tumor was bilobar, the maximum number of tumors removed was 9, and the largest tumor was 8.5 cm in diameter. The 1-, 3- and 5-year overall survival rates were 84, 56.9, and 48.7%, respectively. The 1- and 3-year overall recurrence-free survival rates were 49.6 and 36.2%, respectively, without significant differences between RLS vs. LLS. Conclusion Minimally invasive liver surgery for CRLM is safe and feasible. Minimally invasive resection of multiple lesions and large tumors is also possible. RLS may help to achieve higher rates of R0 resections. High BMI, previous abdominal surgery, and bilobar tumors are not a barrier for MILS. Laparoscopic and robotic liver resections for CRLM provide similar long-term results which are comparable to open techniques.

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