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Anatomical variation of facial nerve in cerebellopontine angle in microvuscular decompression for treatment of idiopathic hemifaciai spasm

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF NEUROSURGERY
Issue:
12
DOI:
10.3321/j.issn:1001-2346.2008.12.003
Key Word:
显微手术;面肌痉挛;面神经;解剖;变异;Microsurgical treatment;Hemifacial spasm;Facial nerve;Anatomy;Variation

Abstract: Objective To study the relationship of anatomical variation of facial nerve in cerebellopentine angle and idiopathic hemifacial spasm and surgical treatment. Methods 10 facial nerve anatomical variations were observed in 1221 microvascular decompressions (MVD) for hemifacial spasm (HFS) from October 2000 to March 2008. The distance between the root exit zoon (REZ) of facial nerve and the root enter zoon (REZ) of vostibulocochlear nerve was more than lOmm. All the 10 patients received MVD( offending artery suspension method was used in 4 eases ). Results The HFS disappeared immediately in 9 patients. The postoperative spasm was weaker in 1 patient and the residual spasm was disappeared within 5 months. The reoccurrence of spasm was observed in 1 patient during follow-up period (2-96 months, mean duration 26.8 months). Postoperative complications included: 2 cases of transient moderate facial paralysis, 3 cases of transient abducent paralysis and 1 case of hearing loss of the operative side. Conclusion It's a really rare condition that the distance between the REZ of facial nerve and the REZ of vestibulocochlear nerve was more than 10mm. The compression of arteries is still the main reason of these HFS patients. The effectiveness could be predicted after MVD. But the rates of facial and/or abducent paralysis were relatively higher. The application of offending artery suspension method was helpful to raise the effective rate and lower the incidence of complications.

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