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Journal of Korean Neurosurgical Society 1994;23(4): 393-401.
The Short-term Result of Micro-Vascular Decompression in Trigeminal Neuralgia and Hemifacial Spasm.
Ho Shin Gwak, Chun Kee Chung, Hyun Jib Kim, Chang Wan Oh, Young Seob Chung, Dong Gyu Kim, Hee Won Jung, Kil Soo Choi, Dae Hee Han
Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea.
The result of microvascular decompression(MVD) in 105 consecutive cases is presented. The symptomatic vasculoneural compressions including tumor, vascular malformation, or aneurysm are excluded in this study group. The 41 patients with trigeminal neuralgia(TN) were all treated by posterior fossa exploration(PEE). Eighteen of them were treated with MVD only, another 14 with partial sensory rhizotomy(PSR) only, and in the other 9 patients, MVD and PSR were performed together. Sixty-twp of 64 hemifacial spasm(HFS) cases were treated succesfully with MVD via PFE. However in one case of which the offending vessel was not identified, neurolysis was carried out. The other case who had both TN and HFS, died due to intraoperative cardiac arrest. The result of operation was evaluated at one month after the operation. In TN, among thirty-nine(98%) patients who resulted in pain-improvement, 32(82%) experienced complete resolution of the pain, The rate complete pain-relief was higher in the 'MVD only group' than in 'group with PSR'. Among 62(94%) cases of HFS, 29(47%) patients obtained 'complete cure' and 'improvement-only' respectively ; only 4(6%) patients had no change of the spasm. The preoperative clinical characteristics, intraoperative surgical findings and postoperative outcomes were itemized and analyzed find out the prognostic factors. The our results are compared with others in the literature.
Key Words: Hemifacial spasm; Trigeminal neuragia; Microvascular decompression; Prognostic factor
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