Clinical significance of lesser occipital nerve preservation during micro-vascular decompression for hemi-facial spasm

Abstract

Micro-vascular decompression (MVD) is a useful surgical technique in treating hemi-facial spasm (HFS). However, sensory disturbance and headache are the common postoperative complications. This study seeked to estimate whether lesser occipital nerve (LON) preservation was conducive to reducing the incidence of adverse events. We retrospectively compared the operation time and postoperative complications between 28 HFS patients who underwent MVD with LON preservation from January 2011 to December 2012 (LON preservation group) and 12 HFS patients who underwent MVD without preserving LON in 2010 (control group). Compared with the control group, patients in the LON preservation group showed increased operation time but reduced incidences of sensory disturbances around occipitalis (P = 0.017) and posterior auricular (P = 0.002). However, there were no significant differences in other postoperative complications such as headache (P = 0.414), incision infection (P = 0.527) or cerebrospinal fluid leakage (P = 0.527). For HFS patients who attempted to receive MVD, LON preservation could reduce the incidence of sensory disturbance around the operative region, despite causing extend operation time.