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Safety and efficacy of endoscope-assisted versus microscopic microvascular decompression surgery for hemifacial spasm: a prospective cohort study

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Abstract

Microscopic microvascular decompression (M-MVD) is a classical treatment for relieving long-term hemifacial spasms (HFS). An endoscopy technique has recently been introduced to improve M-MVD; however, this application remains debatable. This study compared the safety and effectiveness of endoscope-assisted microvascular decompression (EA-MVD) and M-MVD for HFS. From February 2021 to September 2022, we enrolled 49 patients with HFS assigned to the EA-MVD (n = 26) and M-MVD (n = 23) groups. The patients were assessed with Park YS grades, operative time, hospital days, and complications. Evaluations were performed in the early postoperative period, at one month, 3 months, 6 months, and at least 12 months. Twenty-three (23/26, 88.5%) patients in the EA-MVD group and 20 (20/23, 87.0%) patients in the M-MVD group achieved spasm-free relief, ranging over “excellent” and “good” Park YS grades. The operative time in the EA-MVD and M-MVD groups were 143 ± 28 min and 145 ± 22 min (p = 0.002). The duration of hospital stay was 6.8 ± 0.8 days and 7.2 ± 1.3 days in the EA-MVD and M-MVD groups (p = 0.002), respectively. All surgeries for HFS were successful, with no death, stroke, hearing loss, facial numbness, or other extreme complications. In conclusion, EA-MVD, compared with M-MVD, demonstrated equally effective outcomes with decreased operative time and hospital stays, providing bright intraoperative illumination and flexible surgical vision.

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Acknowledgements

The authors thank Hao Yan, MD, for his support of the statistical aspect of this study.

Funding

This research was supported by the Bei**g Nature & Science Foundation of China (grant number Z210009), Research Fund of Science and Technology Innovation 2030—Major Project (grant number 2021ZD0201600), and Bei**g Municipal Administration of Hospitals Incubating Program (PX2022034), the National Natural Science Foundation of China (U20A20391) and Supported by the National Key Research and Development Program of China (No. 2022YFC3602203).

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Author notes

  1. Dou Yang and Wei Shu contributed equally to this work and are considered co-first authors.

Authors and Affiliations

  1. Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun St, Bei**g, China

    Dou Yang, Wei Shu & Hongwei Zhu

  2. Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Bei**g, China

    Tao Du & Junchi Li

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  1. Dou Yang
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Contributions

All the authors had collectively dedicated significant efforts to this study. Wei Shu and Dou Yang formulated the study design. The surgical procedure was performed by Wei Shu, Junchi Li, Tao Du, and Hongwei Zhu. Dou Yang and Hao Yan conducted the statistical analysis. Dou Yang prepared the manuscript and collaborated with Wei Shu to edit it. Hongwei Zhu carried out a thorough review of the manuscript. Wei Shu and Dou Yang guaranteed the integrity of the entire study.

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Correspondence to Hongwei Zhu.

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The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

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The study was conducted according to the principles of the Declaration of Helsinki, and the local ethics committee approved it. The patients or their legal representatives provided written informed consent to participate in this study and surgery.

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Yang, D., Shu, W., Du, T. et al. Safety and efficacy of endoscope-assisted versus microscopic microvascular decompression surgery for hemifacial spasm: a prospective cohort study. Acta Neurol Belg (2024). https://doi.org/10.1007/s13760-024-02539-4

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