Utility of intraoperative electromyography in microvascular decompression for hemifacial spasm: A meta-analysis

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Abstract

Object: In this paper, the authors' goal was to determine the utility of monitoring the abnormal muscle response (AMR) or "lateral spread" during microvascular decompression surgery for hemifacial spasm. Methods: The authors' experience with AMR as well as the data available in the English-language literature regarding resolution or persistence of AMR and the resolution or persistence of hemifacial spasm at follow-up was pooled and subjected to a meta-analysis. Results: The pooled OR revealed by the meta-analysis was 4.2 (95% CI 2.7-6.7). The chance of a cure if the AMR was abolished during surgery was 4.2 times greater than if the lateral spread persisted. Conclusions: The AMR should be monitored routinely in the operating room, and surgical decision-making in the operating room should be augmented by the AMR.

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Sekula, R. F., Bhatia, S., Frederickson, A. M., Jannetta, P. J., Quigley, M. R., Small, G. A., & Breisinger, R. (2009). Utility of intraoperative electromyography in microvascular decompression for hemifacial spasm: A meta-analysis. Neurosurgical Focus, 27(4). https://doi.org/10.3171/2009.8.FOCUS09142

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