반측안면경련증에 대한 미세혈관감압술후 증상소실의 시간적 경과와 수술전 증상의 정도와의 상관관계

초록

PURPOSE : After microvascular decompression (MVD) for hemifacial spasm (HFS), resolution of symptom is often gradual. This study is to investigate relationship between time course of symptom disappearance and pre-operative symptom severity. MATERIALS AND METHODS : In 115 patients with HFS who had MVD from April 2003 to December 2006, 89 patients, who had no facial paralysis after operation and showed no spasm at more than 1.5 years after operation, were selected. Symptom disappearance course with time after MVD was classified into type 1 (symptom disappearance right after operation), type 2 (delayed symptom disappearance) and type 3 (unusual symptom disappearance). Symptom disappearance with time and its relation with symptom severity (mild, moderate and severe) were analyzed. RESULTS : Type 1 was 38.2% and type 2 was 60.7%. In case of type 2, average of postoperative symptom duration was 115.1 days and median was 42 days, being from 5 to 900 days. Cases with severe symptom showed delayed symptom disappearance more often significantly, however probability of symptom disappearance with time was not significantly different depending on symptom severity. All 5 cases that 1 to 2.5 year was needed until symptom disappeared had severe symptom before operation. CONCLUSION : Surgeons should be aware that time course of symptom disappearance after MVD for HFS is various as well as unpredictable and observation for more than 2 years may be necessary in cases with severe preoperative symptom and remained spasm postoperatively.