Microvascular decompression treatment for post-Bell’s palsy hemifacial spasm

Abstract

Objective: This retrospective study is to explore the clinical features and surgical outcomes of the patients who suffered from hemifacial spasm preceded by Bell’s palsy.Methods: Seventeen patients with post-Bell’s palsy hemifacial spasm underwent microvascular decompression surgery. A 3D-TOF-MRA examination was performed pre-operatively to confirm the existence of offending vessels around the facial nerve. Abnormal muscle response was monitored during operation. The results of spasm resolution and post-operative complications were assessed.Results: During operation, offending vessels were found and transposed in 15 patients. For the other two patients in whom offending vessel was absent, the facial nerve was treated by combing. The results of spasm resolution were ‘cured’ in 12 (70·5%) patients, ‘improved’ in 2 (11·8%) patients, ‘fair’ in 2 (11·8%) patient, and ‘failed’ in 1 (5·9%) patient. The complications included transient hearing loss in one case, and deterioration of facial weakness in two cases.Conclusion: Vascular compression may be an etiological factor of post-Bell’s palsy hemifacial spasm, and microvascular decompression is an effective treatment to this disorder.