Articles: microvascular-decompression-surgery.
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Several studies have suggested favorable results with endoscope-assisted microvascular decompression (EA-MVD) for treating patients with trigeminal neuralgia (TN); however, supporting evidence is limited. ⋯ M-MVD and EA-MVD achieved similar analgesic effects for TN; however, EA-MVD allowed observation of more probable offending vessels with good flexible operative visualization.
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Hemifacial spasm (HFS) causes both physical and psychological disabilities that significantly impact quality of life. Medical management with serial botulinum toxin injections provides transient spasm relief and is widely reported as highly effective, as compared to no treatment. ⋯ Although the majority of MVD neurosurgeons maintain a low annual case volume, excellent safety and success rates can be achieved with attention to technical nuances and anatomical appreciation of the target facial root exit zone. Attention to better informing patients and optimizing surgical outcomes should lead to a greater role for neurosurgery in the treatment and cure of HFS.
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Surgical outcomes for functional vestibulocochlear diseases vary, and the influencing factors are not fully understood. The role of a rhomboid lip (RL) and choroid plexus (CP) in microvascular decompression (MVD) of the vestibulocochlear nerve has not been studied. This study aims to evaluate the surgical efficacy of MVD for vestibulocochlear diseases, with and without addressing the RL and CP, to enhance our understanding of their etiology. ⋯ MVD is generally considered a useful treatment for VP and could also be effective in managing recurrent vertigo caused by BPPV and MD. Our results highlight the potential role of an abnormal RL and CP in the development of vertigo symptoms. Patients presenting with "tinnitus" require further investigation and might not be suitable for MVD.
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Journal of neurosurgery · Jan 2024
Preemptive strategies and lessons learned from complications encountered with microvascular decompression for hemifacial spasm.
Microvascular decompression (MVD) is the only curative treatment modality for hemifacial spasm (HFS). Although generally considered to be safe, this surgical procedure is surrounded by many risks and possible complications. The authors present the spectrum of complications that they met in their case series, the possible causes, and the strategies recommended to minimize them. ⋯ MVD is safe and effective for treating HFS with a low rate of permanent morbidity. Proper patient positioning, sharp arachnoid dissection, and endoscopic visualization under facial and auditory neurophysiological monitoring are the key points to minimize the rate of complications in MVD for HFS.