Introduction: Microvascular decompression is an effective treatment modality for hemifacial spasm. Interposition method using prosthesis is usually underwent and it is known that initial success rate is 90 to 95%. However, the recurrence after microvascular decompression was not rare. Here we present about the causes for the recurrent hemifacial spasm after microvascular decompression and our preliminary experience for the transposition method.
Methods: During the last 3 years, we tried to transposition using the Gore-Tex belt at thirty four cases. The patient’s clinical outcome, operative finding were analyzed in cases using transposition method and operative finding, clinical outcome, patient’s outcome and complications were analyzed in recurrent twenty seven cases.
Results: During the last 28 years, recurrence after microvascular decompression was 1.2% at the follow-up over 2years. The most common cause of recurrence was teflon adhesion or granuloma (78%). Postoperative complications were transient facial weakness and transient hearing impairment in two patients respectively. At cases operated by the transposition method, there has been no case of recurrence although the follow-up period was not yet long enough.
Conclusions: For reduce the recurrence after microvascular decompression, initial operation is very important because of reoperation is associated with relatively high risk of complication and technically difficult. And for prevention of adhesion, transposition method is recommended as can as possible although large series of patients with longer follow-up period is necessary.
Patient Care: Recurrence rate after microvascular decompression for hemifacial spasm
is decreased due to using the transposition technique by the gore-tex belt or sling retraction material.
Learning Objectives: Interposition technique in microvascular decompression for hemifacial spasm have a more recurrence rate than transposition technique. And so, for reduction of recurrence, transposition technique is recommended.