Articles: microvascular-decompression-surgery.
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In the present study, we investigated whether blink synkinesis monitoring during microvascular decompression (MVD) is effective for predicting long-term outcomes in patients with hemifacial spasm (HFS). ⋯ Our results demonstrate that blink synkinesis monitoring is safe during MVD for HFS. Furthermore, blink synkinesis was associated with the highest sensitivity and predictive values among the three methods evaluated. These findings suggest that blink synkinesis can be regarded as the first choice for intraoperative monitoring during MVD. Concurrent use of blink synkinesis and LSR monitoring may maximize the ability to predict patient prognosis and determine the extent of decompression.
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Although microvascular decompression (MVD) is the primary treatment for hemifacial spasm (HFS), the postoperative course is variable. This study aimed to develop a prediction model of the outcome of MVD in patients with HFS by investigating influential factors. ⋯ Male sex, mild degree of preoperative spasm, intraoperative indentation on the facial nerve, and postoperative delayed facial palsy were better favorable prognostic factors of MVD in patients with HFS. This novel algorithm may be useful to predict the outcome of MVD in these patients.
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Comparative Study
Comparing Microvascular Decompression with Gamma Knife Radiosurgery for Trigeminal Neuralgia A Cost-effectiveness Analysis.
Both microvascular decompression (MVD) and Gamma Knife radiosurgery (GKRS) are time-tested treatment modalities for trigeminal neuralgia (TN). There is little evidence in the literature studying these modalities head to head in a cost-effectiveness comparison. ⋯ In patients medically eligible for either procedure, we found MVD to be the most cost-effective modality to treat TN, primarily because of its reported greater durability. MVD remained the most cost-effective strategy across a broad range of model input values in sensitivity analyses.
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Hemifacial spasm (HFS) is generally caused by the root exit zone of the facial nerve compressed by an overlying arterial loop. HFS can also be caused by various types of tumor, aneurysm, or arteriovenous malformation. We retrospectively analyzed patients to evaluate possible differences in the demographic and clinical features between primary and secondary HFS. ⋯ In cases of secondary HFS, facial nerves of most patients were compressed by blood vessels, so microvascular decompression after tumor resection plays an important role. We should examine the entire nerve root for possible vascular compression.
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Review Case Reports
Repositioning Technique for the Decompression of Symptomatic Dolichoectatic Vertebrobasilar Pathology: A Comprehensive Review of Sling Characteristics and Surgical Experiences.
The repositioning of a dolichoectatic vertebrobasilar artery (VBA) for arterial decompression has been extensively used in the clinical setting. We aimed to describe and summarize the technical characteristics and clinical results of the sling technique. ⋯ The excellent surgical outcomes and durable long-term results suggest that the repositioning technique is highly effective in resolving symptoms related to the compression of DVB pathology. The wrap-sling technique might be the preferred option owing to the simultaneous symptom relief and lower rate of temporary complications. However, cranial nerve manipulation should be meticulously implemented to avoid permanent negative effects.