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 REVIEW ARTICLE
Year : 2017  |  Volume : 65  |  Issue : 3  |  Page : 493--505

Microvascular decompression for hemifacial spasm: A systematic review of vascular pathology, long term treatment efficacy and safety


1 Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
2 Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Dr. Kanwaljeet Garg
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/neuroindia.NI_1166_16

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Introduction: Hemifacial spasm (HS) is a rare disorder caused by the compression of facial nerve root exit zone (REZ) at the brainstem by a vascular loop. Microvascular decompression (MVD) is a popular treatment modality for HS. Objective: The purpose of this study was to determine the long-term efficacy and safety of MVD for HS by assessing the effect of the procedure from the literature published over the last 25 years. Materials and Methods: A systematic data review from 1992 to 2015 using specific eligibility criteria yielded 27 studies on MVD for HS, the data of which were pooled and subjected to a meta-analysis. Results: The pooled odds ratio (OR) revealed by the meta-analysis showed that anterior inferior cerebellar artery was the most common offending vessel in 37.8% (95% confidence interval [CI]: 27.8–47.7%) of the patients. Complete resolution of HS was seen in 88.5% (95% CI: 86.7–90.4%) of the patients after a long-term follow up. The complication rate was low following MVD, the most common being temporary facial paresis in 5.9% (95% CI: 4.3–7.5%) of patients. Conclusions: MVD is a safe and effective treatment for HS with long-term benefits and a low complication rate.






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