Long-term Outcomes of Microvascular Decompression Surgery for Hemifacial Spasm: A Clinical Series

Objective: Hemifacial spasm (HFS) is a challenging neurological disorder frequently managed with microvascular decompression (MVD) surgery.This retrospective investigation evaluates the efficacy and outcomes of MVD procedures on patients with HFS at our institution between 2015 and 2023.Materials and Methods: Forty-six patients diagnosed with HFS based on clinical evaluations, physical examinations, electromyography (EMG), and imaging studies were included.Patients were selected for surgery based on their ability to handle surgical risk and evidence of likely vascular compression.Postoperatively, patients were assessed at regular intervals to evaluate the long-term outcomes of MVD surgery.Results: MVD surgery resulted in an 84.8%rate of "Excellent" and "Good" outcomes.Arterial compression was commonly observed during surgery, with anterior inferior cerebellar artery (AICA) compression being most frequent.The outcomes were less successful in cases with petrosal venous compression.A low complication rate was noted, with no permanent neurological deficits or mortality.However, reoperation was required in 8.6% of patients due to symptom recurrence. Conclusion:This study reinforces the efficacy and safety of MVD as a primary surgical treatment for HFS.With a high success rate and a low incidence of complications, MVD provides substantial and lasting symptom relief for most patients.Our findings highlight the importance of identifying vascular compression patterns to optimize surgical outcomes.Future large-scale, multicenter studies will further refine patient selection and surgical strategies to enhance long-term success rates.