A multivariable prediction model for recovery patterns and time course of symptoms improvement in hemifacial spasm following microvascular decompression

作者：Ahmed Al Menabbawy, Ehab El Refaee, Reem Elwy, Amany A. Salem, Sebastian Lehmann, Marcus Vollmer, Marc Matthes, Steffen Kristian Fleck, Jörg Baldauf, Henry W. S. Schroeder · 发表于：Acta Neurochirurgica · 年份：2022 · DOI：10.1007/s00701-022-05133-w · 被引用次数：18 · 研究领域：Trigeminal Neuralgia and Treatments、Temporomandibular Joint Disorders、Facial Nerve Paralysis Treatment and Research

BACKGROUND: Microvascular decompression (MVD) success rates exceed 90% in hemifacial spasm (HFS). However, postoperative recovery patterns and durations are variable. OBJECTIVE: We aim to study factors that might influence the postoperative patterns and duration needed until final recovery. METHOD: Only patients following de-novo MVD with a minimum follow-up of 6 months were included. Overall trend of recovery was modeled. Patients were grouped according to recognizable clinical recovery patterns. Uni- and multivariable analyses were used to identify the factors affecting allocation to the identified patterns and time needed to final recovery. RESULTS: A total of 323 (92.6%) patients had > 90% symptom improvement, and 269 (77.1%) patients had complete resolution at the last follow-up. The overall trend of recovery showed steep remission within the first 6 months, followed by relapse peaking around 8 months with a second remission ~ 16 months. Five main recovery patterns were identified. Pattern analysis showed that evident proximal indentation of the facial nerve at root exit zone (REZ), males and facial palsy are associated with earlier recovery at multivariable and univariable levels. anterior inferior cerebellar artery (AICA), AICA/vertebral artery compressions and shorter disease durations are related to immediate resolution of the symptoms only on the univariable level. Time analysis showed that proximal indentation (vs. distal indentation), males and facial palsy witnes...