Delayed recurrence of hemifacial spasm after successful microvascular decompression: follow-up results at least 5 years after surgery
Delayed recurrence of hemifacial spasm after successful microvascular decompression: follow-up results at least 5 years after surgery
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DOI：
10.1007/s00701-012-1424-z
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发表时间：
2012-09-01
影响因子：
2.4
通讯作者：
Chang, Jin Woo
中科院分区：
文献类型：
--
作者：
Chang, Won Seok;Chung, Jong Chul;Chang, Jin Woo
微血管减压术（MVD）治疗面肌痉挛（HFS）因其有效性和持久性而被视为金标准治疗。然而，一些患者仍然遭受延迟复发后，最初成功的MVD。在这项研究中，我们描述了我们的临床经验，在一个单一的研究所随访最初成功的MVD HFS手术后5年或更长时间。我们回顾性分析了1999年3月至2006年6月间587例符合纳入标准的HFS患者的资料，分析了延迟复发的概率、风险/诱发因素和时间。我们评估了复发的时间依赖性概率和影响延迟复发的因素以及复发时间，术后1年、2年和5年的延迟复发概率分别为1.0%、1.7%和2.9%。平均至复发时间为153.1个月（95%置信区间[151.4-154.9]）。合并动脉高血压患者晚期复发的概率增加（p = 0.036）。然而，有一种趋势，即延迟复发与年轻，男性，静脉或VA罪犯共存，短暂的面部weakness.Delayed复发HFS后，最初成功的MVD是罕见的，但是，有患者经历延迟复发MVD后超过2年，甚至5年后MVD。我们的研究结果表明，动脉高血压有助于晚期复发。我们没有发现复发与其他假定的风险/诱发因素之间存在统计学显著关系。
Microvascular decompression (MVD) for hemifacial spasm (HFS) is regarded as the gold-standard treatment due to its efficacy and durability. However, some patients still suffer from delayed recurrence after initially successful MVD.In this study, we describe our clinical experience in a single institute following up initially successful MVD for HFS 5 or more years after surgery. We analyzed the probability of, risk/predisposing factors for, and timing of delayed recurrence.We retrospectively reviewed data from 587 patients meeting our inclusion criteria who underwent MVD for HFS from March, 1999, to June, 2006. We evaluated the time-dependent probability of recurrence and factors affecting delayed recurrence and time of recurrence.The probability of delayed recurrence was 1.0, 1.7, and 2.9 % at 1 year, 2 years, and 5 years after surgery, respectively. Mean time to recurrence was 153.1 months (95 % confidence interval [151.4-154.9]). The probability of late recurrence was increased in patients with co-morbid arterial hypertension (p = 0.036). However, there was a trend towards an association of delayed recurrence with co-existence of young age, male gender, vein or VA offender, and experience of transient facial weakness.Delayed recurrence of HFS after initially successful MVD is rare; however, there are patients who experience delayed recurrence more than 2 years after MVD, even until 5 years after MVD. Our results suggest that arterial hypertension contributes to late recurrence. We did not find a statistically significant relationship between recurrence and other putative risk/predisposing factors.