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This article describes results of a multicentre prospective trial performed to evaluate long- and short-term outcomes and complications of patients who underwent microvascular decompression (MVD) for hemifacial spasm (HFS). The surgeries were performed by surgeons with more than 15 years of experience at high volume centres in Japan. A total of 486 patient were enrolled for the study from April 2012 to March 2015, and 463 completed a three-year follow-up. The authors’ data is interesting as they discuss outcomes over short follow-up periods of first week and one year, and long-term follow-up of three years, showing patients who significantly improved, as well as those patients whose outcome worsened. Their results describe a lower immediate cure rate as well as a lower complication rate when the abnormal muscle response (AMR) was used to determine the efficacy of decompression. However, it appears that majority of the patients with mild residual spasm at short-term follow-up had complete resolution over the long-term follow-up. In patients with HFS due to vertebral artery compression, a higher rate of complications was noted by the authors, but these patients also had positive outcomes at the long-term follow-up. Complications included hearing loss, facial nerve paresis, and lower cranial nerve injuries. The authors conclude that MVD is an effective and safe treatment for all patients, including the elderly, with HFS. – GM

Prospective, multicenter clinical study of microvascular decompression for hemifacial spasm.
Mizobuchi Y, Nagahiro S, Kondo A, et al.
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Gauri Mankekar

Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.

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