Delayed Facial Palsy After Microvascular Decompression Or Hemifacial Spasm Introduction

Objective:To explore the risk factors of delayed facial paralysis(DFP)after microvascular decompression(MVD)for hemifacial spasm(HFS).Methods:639 patients with HFS admitted to the same operation from January 2006 to May 2016 were retrospectively enrolled.All patients received MVD treatment.Among them,53 cases(8.3%)had DFP,which occurred from the 2nd day to the 60th day after operation,with an average of 12.9 days(SD=10.0005).Among the other 50 patients with DFP,50(100%)recovered completely from 10 to 300 days after onset,with an average of 88.7 days(SD=61.389).Fifty patients with DFP were selected as case group and 100 patients without DFP were randomly selected as control group.Univariate and multivariate logistic analysis was used to analyze the risk factors that might affect the occurrence of DFP.Spearman test was used to analyze the relationship between the onset time of DFP and the duration of DFP symptoms.Results:Univariate analysis showed that duration was the only factor associated with DFP(P=0.003).Multivariate logistic analysis was conducted for the dependent variables(age,arachnoid adhesion,HFS grade,course of disease)of P<0.2 and the risk factors(hypertension)pointed out in other previous studies.The results show that the course of HFS is still the only risk factor associated with DFP(P=0.01),even the independent risk factor.Spearman test was used to verify the relationship between the onset time of DFP and the duration of DFP symptoms(rs=0.6825P<0.001),We found a positive correlation,that is,the earlier DFP occurs,the shorter the duration of symptoms.Conclusions:Although DFP frequently occurred after MVD,it can recover spontaneously.The longer the course of HFS lasts,the more frequently DFP will occur after MVD.The earlier DFP occurs,the shorter it takes to recover.