Prognostic value of intra-operative lateral spread response monitoring during microvascular decompression in patients with hemifacial spasm

2008 ◽  
Vol 15 (12) ◽  
pp. 1335-1339 ◽  
Author(s):  
Won-Il Joo ◽  
Kyung-Jin Lee ◽  
Hae-Kwan Park ◽  
Chung-Kee Chough ◽  
Hyoung-Kyun Rha
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Prognostic Value ◽  
Lateral Spread ◽  
Response Monitoring ◽  
Lateral Spread Response

Lateral spread response monitoring during microvascular decompression for hemifacial spasm

2014 ◽  
Vol 63 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Y.H. Chung ◽  
W.H. Kim ◽  
J.J. Lee ◽  
S.-I. Yang ◽  
S.H. Lim ◽  
...  
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Lateral Spread ◽  
Response Monitoring ◽  
Lateral Spread Response

Microvascular decompression for hemifacial spasm: can intraoperative lateral spread response monitoring improve surgical efficacy?

2018 ◽  
Vol 128 (3) ◽  
pp. 885-890 ◽  
Author(s):  
Yongxu Wei ◽  
Wenlei Yang ◽  
Weiguo Zhao ◽  
Chunhua Pu ◽  
Ning Li ◽  
...  
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Lateral Spread ◽  
Response Monitoring ◽  
Cut Elimination ◽  
Clear Cut ◽  
Significant Difference ◽  
Group A ◽  
Lateral Spread Response ◽  
Group B

OBJECTIVEThe purpose of this study was to evaluate whether intraoperative monitoring of lateral spread response (LSR) improves the efficacy of microvascular decompression (MVD) for hemifacial spasm (HFS).METHODSIn this prospective study, patients undergoing MVD for HFS were assigned to one of 2 groups, Group A (MVD with intraoperative LSR monitoring) or Group B (MVD without LSR monitoring). Clinical outcome at 12 months after surgery was assessed through telephone survey. Data analysis was performed to investigate the effect of intraoperative LSR monitoring on efficacy of MVD.RESULTSA total of 283 patients were enrolled in the study, 145 in Group A and 138 in Group B. There was no statistically significant difference between the 2 groups with respect to the percentage of patients who had spasm relief at either 1 week (Group A 87.59% vs Group B 83.33%; p = 0.317) or 1 year (93.1% vs 94.2%; p = 0.809) after surgery. A clear-cut elimination of LSR during surgery was observed in 131 (90.34%) of 145 patients; LSR persisted in 14 patients (9.66%) at the end of the surgical procedure. Disappearance of LSR correlated with spasm-free status at 1 week postoperatively (p = 0.017) but not at 1 year postoperatively (p = 0.249).CONCLUSIONSIntraoperative LSR monitoring does not appear to provide significant benefit with respect to the outcome of MVD for HFS in skilled hands. Persistence of LSR does not always correlate with poor outcome, and LSR elimination should not be pursued in all patients after verification of complete decompression.

scholarly journals Prognostic ability of intraoperative electromyographic monitoring during microvascular decompression for hemifacial spasm to predict lateral spread response outcome

2017 ◽  
Vol 126 (2) ◽  
pp. 391-396 ◽  
Author(s):  
Sung Ho Lee ◽  
Bong Jin Park ◽  
Hee Sup Shin ◽  
Chang Kyu Park ◽  
Bong Arm Rhee ◽  
...  
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Prognostic Value ◽  
University Hospital ◽  
Lateral Spread ◽  
Symptom Duration ◽  
Group A ◽  
Lateral Spread Response ◽  
Group B

OBJECTIVE Abnormal lateral spread response (LSR) is a typical finding in facial electromyography (EMG) in patients with hemifacial spasm (HFS). Although intraoperative monitoring of LSR has been widely used during microvascular decompression (MVD), the prognostic value of this monitoring is still debated. The purpose of this study was to determine whether such monitoring exhibits prognostic value for the alleviation of LSR after treatment of HFS. METHODS Between January 2009 and December 2013, a total of 582 patients underwent MVD for HFS with intraoperative EMG monitoring at Kyung Hee University Hospital. The patients were categorized into 1 of 2 groups according to the presence of LSR at the conclusion of surgery (Group A, LSR free; Group B, LSR persisting). Patients were assessed for the presence of HFS 1 day, 6 months, and 1 year after surgery. Various parameters, including age, sex, symptom duration, offending vertebral artery, and offending perforating artery, were evaluated for their influence on surgical and electrophysiological results. RESULTS Overall, HFS was alleviated in 455 (78.2%) patients 1 day after MVD, in 509 (87.5%) patients 6 months after MVD, and in 546 (93.8%) patients 1 year after MVD. Patients in Group B were significantly younger than those in Group A (p = 0.022). Patients with a symptom duration of less than 1 year were significantly more likely to be classified in Group A than were patients whose symptoms had persisted for longer than 10 years (p = 0.023); however, analysis of the entire range of symptom durations did not reveal a significant effect (p = 0.132). A comparison of Groups A and B according to follow-up period revealed that HFS recovery correlated with LSR alleviation over a shorter period, but the same was not true of longer periods; the proportions of spasm-free patients were 80.6% and 71.1% (p = 0.021), 89.4% and 81.9% (p = 0.022), and 93.5% and 94.6% (p = 0.699) 1 day, 6 months, and 1 year after surgery in Groups A and B, respectively. CONCLUSIONS Although intraoperative EMG monitoring during MVD was beneficial for identifying the offending vessel and suggesting the most appropriate surgical end point, loss of LSR did not always correlate with long-term HFS treatment outcome. Because the HFS cure rate improved over time, revision might be considered for persistent LSR when follow-up has been performed for more than 1 year and the spasm remains despite adequate decompression.

The novel prognostic value of postoperative follow-up lateral spread response after microvascular decompression for hemifacial spasm

2021 ◽  
pp. 1-5
Author(s):  
Minjae Cho ◽  
So Young Ji ◽  
Kyeong-O Go ◽  
Kyung Seok Park ◽  
Jong-Min Kim ◽  
...  
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Prognostic Value ◽  
Lateral Spread ◽  
Trend Test ◽  
Time Interval ◽  
Electrophysiological Response ◽  
The Status ◽  
Lateral Spread Response

OBJECTIVE The lateral spread response (LSR) is an aberrant electrophysiological response in which a stimulus on one branch of the facial nerve spills over to other branches of the nerve, which can be captured by electrodes near each branch. The authors performed this study to evaluate the prognostic value of the follow-up LSR with a sufficient time interval from intraoperative LSR (IO-LSR) after microvascular decompression (MVD) for hemifacial spasm (HFS), excluding the interference of various intraoperative situations. METHODS A total of 247 patients treated with MVD for HFS between June 2011 and March 2019 were enrolled in this study. The IO-LSR was routinely evaluated in all patients. The LSR was checked again on postoperative day (POD) 2 after surgery (POD2-LSR). A total of 228 patients (92.3%) were considered cured at the last clinical follow-up. RESULTS The IO-LSR disappeared in 189 patients (76.5%), and among them, 181 patients (95.8%) were cured 1 year after surgery. The POD2-LSR disappeared in 193 patients (78.1%), and 185 patients (95.9%) among them were cured. Among the 189 patients in which the IO-LSR disappeared, the POD2-LSR reappeared in 26 patients (13.8%). In contrast, the POD2-LSR disappeared in 30 (51.7%) of 58 patients for whom the IO-LSR continued at the end of surgery. When classified into groups according to the status of the IO-LSR and POD2-LSR, in the group of patients in whom both LSRs disappeared, the cure rate was 98.2%, which was significantly higher than that of the other 3 groups (p < 0.05, Cochran-Armitage trend test). The use of both LSRs was found to be significantly associated with better predictability (p < 0.05, McNemar’s test). CONCLUSIONS Postoperative follow-up LSR examination may be beneficial in predicting clinical outcomes after MVD for HFS, especially when considered together with IO-LSR.

scholarly journals Fully endoscopic microvascular decompression for hemifacial spasm

2019 ◽  
Vol 131 (3) ◽  
pp. 813-819 ◽  
Author(s):  
Tracy M. Flanders ◽  
Rachel Blue ◽  
Sanford Roberts ◽  
Brendan J. McShane ◽  
Bryan Wilent ◽  
...  
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Complete Resolution ◽  
Auditory Evoked Potentials ◽  
Contact Point ◽  
Clinical Status ◽  
Senior Author ◽  
Lateral Spread ◽  
Response Monitoring ◽  
Lateral Spread Response

OBJECTIVEHemifacial spasm (HFS) is characterized by involuntary tonic and/or clonic contractions of facial nerve muscles. Fully endoscopic microvascular decompression (E-MVD) for HFS has not been widely adopted. This paper aims to illustrate the safety and efficacy of the fully endoscopic technique for HFS treatment.METHODSThe authors conducted a single-center retrospective study of 27 patients (28 separate E-MVD cases; 1 patient had bilateral E-MVD) diagnosed with HFS who underwent fully E-MVD from January 2013 to October 2016. Intraoperative brainstem auditory evoked potentials and lateral spread resolution were reviewed. Outcome was based on the clinical status of the patient at the last contact point with the senior author. Complications were categorized as facial weakness, hearing loss, ataxia, dysphagia, or any adverse event able to be attributed to the surgical procedure.RESULTSHFS was relieved either completely or partially in the majority of cases (24 of 28, 85.7%). Of the 28 separate procedures, 17 (60.7%) resulted in complete resolution of symptoms, 4 (14.3%) resulted in near-complete resolution, 2 (7.1%) resulted in 50% reduction of symptoms, 1 (3.6%) resulted in minimal reduction, and 4 (14.3%) resulted in no relief. Of the 27 patients, 26 (96%) had no permanent postoperative complications. In multivariate logistic regression, the best predictor of greater than 50% resolution of spasm was resolution of intraoperative lateral spread response.CONCLUSIONSA fully E-MVD for HFS provides a safe and comprehensive view of the neurovascular conflict. Exclusive use of the endoscope in MVD is both safe and feasible in the treatment of HFS. Attention to lateral spread response monitoring remains an integral part of comprehensive neurosurgical management.

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

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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