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Background <p>Microvascular decompression (MVD) is an established treatment for hemifacial spasm (HFS). However, when the vertebral artery (VA) is the offending vessel (OV), the procedure is technically more challenging. Whether MVD yields comparable safety and efficacy in VA-associated versus non-VA-associated cases remains unclear and warrants further investigation.</p> Materials and methods <p>We conducted a retrospective analysis of HFS patients treated at our study between September 2023 to February 2024. We enrolled 51 patients with HFS assigned to the two groups in accordance with the OVs.</p> Results <p>A total of 51 patients with HFS were divided into the VA-associated (n = 11) and non-VA-associated (n = 40) groups. Spasm-free relief (Park YS grades “excellent” or “good”) was achieved in 81.8% and 82.5% of patients in the VA and non-VA groups, respectively (p = 0.694). Early remission occurred in 45.5% of VA cases and 52.5% of non-VA cases (p = 0.904). Transient postoperative complications, including vertigo, tinnitus, hearing loss, or facial paralysis, were noted in 7 VA-associated (63.6%) and 10 non-VA-associated (25.0%) patients (p <InlineEquation ID="IEq1"> <EquationSource Format="TEX">\(&lt;\)</EquationSource> </InlineEquation> 0.05). Mean operative times were 147 ± 20.0&#xa0;min in VA group) and 131.0 ± 30.0&#xa0;min in non-VA group(p <InlineEquation ID="IEq2"> <EquationSource Format="TEX">\(&lt;\)</EquationSource> </InlineEquation> 0.05) s. No major complications were observed in either group.</p> Conclusion <p>MVD is effective and safe for both VA- and non-VA-associated HFS. Although VA-associated cases involve greater surgical complexity and a higher incidence of transient postoperative symptoms, long-term outcomes remain comparable when adequate decompression is achieved.</p>

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The outcome of microvascular decompression for hemifacial spasm associated with vertebral artery: A retrospective comparative study

  • 期刊论文

  • 发表日期：

    2026年5月18日

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  • Shengyuan Liu,
  • Dou Yang,
  • Chunyue You,
  • Limei Luo,
  • Chuandong Liang,
  • Tao Du

摘要

Background

Microvascular decompression (MVD) is an established treatment for hemifacial spasm (HFS). However, when the vertebral artery (VA) is the offending vessel (OV), the procedure is technically more challenging. Whether MVD yields comparable safety and efficacy in VA-associated versus non-VA-associated cases remains unclear and warrants further investigation.

Materials and methods

We conducted a retrospective analysis of HFS patients treated at our study between September 2023 to February 2024. We enrolled 51 patients with HFS assigned to the two groups in accordance with the OVs.

Results

A total of 51 patients with HFS were divided into the VA-associated (n = 11) and non-VA-associated (n = 40) groups. Spasm-free relief (Park YS grades “excellent” or “good”) was achieved in 81.8% and 82.5% of patients in the VA and non-VA groups, respectively (p = 0.694). Early remission occurred in 45.5% of VA cases and 52.5% of non-VA cases (p = 0.904). Transient postoperative complications, including vertigo, tinnitus, hearing loss, or facial paralysis, were noted in 7 VA-associated (63.6%) and 10 non-VA-associated (25.0%) patients (p \(<\) 0.05). Mean operative times were 147 ± 20.0 min in VA group) and 131.0 ± 30.0 min in non-VA group(p \(<\) 0.05) s. No major complications were observed in either group.

Conclusion

MVD is effective and safe for both VA- and non-VA-associated HFS. Although VA-associated cases involve greater surgical complexity and a higher incidence of transient postoperative symptoms, long-term outcomes remain comparable when adequate decompression is achieved.