Long-term Outcomes of Microvascular Decompression in the Treatment of Hemifacial Spasm Based on Different Offending Vessels

OBJECTIVE: To evaluate clinical features, outcomes, and complications in patients with hemifacial spasm (HFS) after microvascular decompression (MVD) of different offending vessels. METHODS: Clinical data were collected from 362 patients with HFS treated with MVD between January 2013 and January 2014. Patients were divided into five groups based on the offending vessel: A (anterior inferior cerebellar artery [AICA] compression), B (posterior inferior cerebellar artery [PICA] compression), C (AICA plus PICA compression), D (vertebral artery [VA] compression), and E (VA plus small vessel compression). RESULTS: The most common offending vessel was the AICA (51.38%). The most common compression site was the root exit zone. During the follow-up period, the effective rate was 95.48% in group A, 92.15% in group B, 93.10% in group C, 90.14% in group D, and 91.45% in group E. Twenty-nine patients exhibited delayed facial palsy, the most common complication. CONCLUSION: No statistically significant differences were found in long-term outcomes or MVD-related complications among the study groups. The type of offending vessel was not a prognostic factor for MVD in patients with HFS.