Objective To investigate the causes and therapy of complications of microvascular decompression (MVD) for hemifacial spasm (HFS). Method Totally 255 cases of HFS underwent MVD in our hospital from December 2000 to March 2000. Among the cases,207 patients were followed up for more than 1 year,the occurrence and recovery of their postoperative complications were reviewed in this study. Results In this series,no patient died;cerebrospinal fluid leakage was detected in 15 patients (7.2%) in one week after the operation;facial palsy occurred in 48 cases (23.2%);hearing deficit was shown in 20 patients (9.7%);and tinnitus was found in 12 cases (5.8%). The patients were followed up for 1 to 7.3 years with a mean of (4.2?2.7) years,during the period,none of the cases had cerebrospinal fluid leakage or intracerebral infection,and the cases who had facial palsy and tinnitus recovered completely;only 10 patients remained hearing deficit (including unilateral deaf in 6) during the follow-up.Conclusion Cerebrospinal fluid leakage,facial palsy,hearing deficit,tinnitus are the major complications of MVD,among which cerebrospinal fluid leakage,facial palsy,and tinnitus can be improved after treatments,but hearing deficit is non-reversible.

Objective To explore the curative effect of microsurgery via posterior approach through the sigmoid sinus in the treatment of secondary trigeminal neuralgia. Methods Clinical data of 37 cases of trigeminal neuralgia secondary to cerebellopontine angle (CPA) tumor from October 2000 to July 2006 were studied, including 18 cases of cholesteatoma, 8 cases of meningoma, 6 cases of acoustic neuroma, and 5 cases of trigeminal schwannoma. All tumors were removed with microsurgery through a posterior approach by way of the sigmoid sinus. Results A total resection was achieved in 23 cases, a subtotal resection in 10 cases, and a partial resection in 4 cases. Symptoms of neuralgia disappeared in 35 cases (including 32 cases of immediate relief and 3 cases of relief 2 months after operation). There was no improvement in 2 cases. Conclusions Microsurgery via posterior approach through the sigmoid sinus in the treatment of secondary trigeminal neuralgia is safe and effective.

Objective To explore the causes of persistent abnormal muscle response (AMR) after microvascular decompression (MVD) for hemifacial spasm (HFS) and the clinical outcomes of these patients.Methods MVD was performed under intraoperative electrophysiological monitoring of AMR in 372 HFS patients in 2014.Before MVD,the characteristic AMR of HFS was recorded in 326 patients.The patients were divided into two groups based on whether AMR disappeared or persisted following MVD;21 patients showed persistent AMR after successful MVD while AMR disappeared after decompression in the other 305 patients.The clinical features,treatment efficacy and postoperative complications were compared between these two groups.Results Gender,side of depression and mean age between the two groups showed no significant differences (P＞0.05).The immediate postoperative cure rate of the AMR disappeared group (88.9％) was significantly higher than that in the AMR persisted group (28.6％,P＜0.05).The follow-up cure rate showed no significant difference between the two groups (P＞0.05),and the postoperative and follow-up complications showed no significant differences (P＞0.05).Conclusion The long duration of HFS patients may be responsible for persistent AMR after successful decompression,and it is more likely for these patients to get delayed cured;their long-term outcomes showed no difference as compared with those in patients with disappeared AMR after MVD.