Reoperation for hemifacial spasm

Abstract

Despite the high success rate of microvascular decompression procedures for hemifacial spasm and trigeminal neuralgia, failure and recurrence are unavoidable. If the spasm or pain does not resolve after surgery and the surgeon thinks perhaps some culprit vessels were neglected in the fi rst operation, early reoperation is indicated. If the symptoms persist for a long period after surgery and delayed resolution does not take place, late reoperation should be performed. Besides, late reoperation is indicated for recurrence. The uncertainty of “delayed resolution” and the high risk of complications of the reoperation make the decision very difficult.