Predictive value of intraoperative blink reflex monitoring for surgical outcome during microvascular decompression for hemifacial spasm |
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| Affiliation: | 1. Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul,Republic of Korea;2. Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;1. Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;2. Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea;3. Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;4. Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;1. Department of Neuroscience, Biomedicine and Movement Sciences, Section of Neurosurgery, University of Verona, Verona, Italy;2. Institute of Psychology, CIMEC – Center for Mind/Brain Sciences, Trento, Italy;3. Division of Neurology, Verona University Hospital, Verona, Italy;4. Department of Neuroradiology, Verona University Hospital, Verona, Italy;1. Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea;2. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;3. Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;4. Nursing, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;5. Department of Neurosurgery, Uijeungbu St.Mary''s Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea;1. Department of Intraoperative Neurophysiology. Mount Sinai West Hospital. New York, NY, USA;2. Department of Intraoperative Neurophysiology. Queen''s Hospital. Barking, Havering, and Redbridge University Hospitals NHS Trust. London, UK;3. Department of Neurosurgery. Inselspital Bern University Hospital, Bern, Switzerland;4. Department of Clinical Neurophysiology. Complejo Hospitalario de Navarra, Pamplona, Spain;5. Department of Neurosurgery. Queen''s Hospital. Barking, Havering, and Redbridge University Hospitals NHS Trust. London, UK;6. Department of Neurosurgery. Mount Sinai West Hospital. New York, NY, USA;7. Albert Einstein College of Medicine, New York, NY, USA;8. Department of Neurosurgery, University Hospital Dubrava, Zagreb, Croatia |
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| Abstract: | ObjectiveTo investigate the prognostic and predictive value of intraoperative blink reflex (BR) monitoring during microvascular decompression (MVD) for hemifacial spasm (HFS).MethodsWe retrospectively reviewed 41 patients with HFS undergoing MVD with intraoperative BR and lateral spread response (LSR) monitoring. Facial spasm was evaluated for six months postoperatively.ResultsThe BR resolved in 38 patients and persisted in three after MVD. For patients who exhibited BR resolution, 1-day, 1-month, and 6-month follow-ups revealed that 35 (92.1%), 35 (92.1%), and 38 (100%) patients had spasm resolution, respectively. However, of the three patients with persistent BR, one (33.3%), one (33.3%), and zero (0%) patients exhibited spasm resolution at the three corresponding follow-ups. We found a statistically significant difference in spasm resolution between the persistent and resolved BR groups at six months postoperatively. A comparison between intraoperative BR and LSR monitoring revealed that BR was a better predictor of clinical outcomes.ConclusionsIntraoperative BR monitoring is a potentially useful tool to help facilitate an adequate decompression and is a reliable prognostic predictor of surgical outcome.SignificanceThis study is the first to document the relationship between intraoperative BR monitoring and surgical outcome in patients with HFS. |
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| Keywords: | Hemifacial spasm Microvascular decompression Intraoperative neurophysiological monitoring Blink reflex Lateral spread response BR" },{" #name" :" keyword" ," $" :{" id" :" k0035" }," $$" :[{" #name" :" text" ," _" :" blink reflex HFS" },{" #name" :" keyword" ," $" :{" id" :" k0045" }," $$" :[{" #name" :" text" ," _" :" hemifacial spasm LSR" },{" #name" :" keyword" ," $" :{" id" :" k0055" }," $$" :[{" #name" :" text" ," _" :" lateral spread response MVD" },{" #name" :" keyword" ," $" :{" id" :" k0065" }," $$" :[{" #name" :" text" ," _" :" microvascular decompression |
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