Article
The value of lateral spread response monitoring in predicting the clinical outcome after microvascular decompression in hemifacial spasm: A prospective study on 50 patients
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Published: | June 2, 2015 |
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Objective: To assess the value of LSRs intraoperative monitoring as a prognostic indicator for the outcome of microvascular decompression in hemifacial spasm.
Method: Our study included 50 patients prospectively. The patients were classified into 4 groups whether LSRs were totally, partially, not relieved or not detected from the start. According to clinical outcome, the patients were classified into 4 groups depending on the clinical course after surgery and the residual symptoms if any. Then, correlations were made between LSRs events and treatment outcome to detect its reliability as a prognostic indicator.
Results: LSRs were relieved totally in 64% of the patients, partially relieved in 14%, not relieved in 6% and were not detected in 16% of the patients from the start. HFS was relieved directly after operation in 66% with clinical improvement of 90-100%. 26% described 50-90% improvement over the next 3 months after surgery. 4% suffered from a relapse after a HFS-free period and 4% reported minimal or no improvement describing 0-50% of the preoperative state. The percentage of the satisfied patients with the clinical outcome (improvement 90-100%) was 90%. Statistical analysis did not find a significant correlation between the relief of LSRs and clinical outcome.
Conclusions: LSRs were valuable as an intraoperative clue of adequate decompression but failed to represent a reliable prognostic indicator for treatment outcome.