Microneurosurgery treatment for comorbidity of hemifacial spasm and glossopharyngeal neuralgia:An analysis of 5 cases

Objective To explore the pathogenesis, clinical characteristics and surgical treatment of comorbidity of hemifacial spasm (HFS) and glossopharyngeal neuralgia (GN). Methods Five cases with HFS and GN underwent the keyhole operation of microvascular decompression (MVD) through retrosignoid approach from January 2014 to June 2016 at Neurosurgery Department, China-Japan Friendship Hospital, and were enrolled into this retrospective study. Five cases were followed up through telephone post operation for evaluation of surgical efficacy and complications. Results The symptom of HFS completely disappeared in all 5 patients which included immediate relief in 4 cases and delayed remission (2 months post surgery) in 1 case. Neuralgia disappeared in all cases including 4 with immediately effect and 1 with delayed remission (4 days post operation). The follow-up period ranged from 1.0 to 3.5 years with an average of (1.5±0.1) years. During the follow-up period, there was no recurrence or surgical complications reported such as facial paralysis, hearing loss and cerebrospinal fluid leakage. Conclusions The comorbidity of HFS and GN is rare, which seems to be mainly caused by vascular compression of entry/exit zone of cranial nerves and could be surgically well treated by MVD. Key words: Microvascular decompression; Hemifacial spasm; Glossopharyngeal neuralgia; Treatment outcome