Clinical neurology and neurosurgery · 2026
Factors associated with recurrence after microvascular decompression for hemifacial spasm: A comprehensive analysis stratified by postoperative recovery patterns.
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Liu Siyi, He Liu, Huang Yunjian, Jiang Zaiying, Xu Shiyun, Hou Feng, Zu Wei, Ni Bing, Lu Guang, Du Tao, Wang Yunpeng, Zhu Hongwei
Аннотация
OBJECTIVE: To examine recurrence after microvascular decompression (MVD) for hemifacial spasm (HFS) and determine whether recurrence correlates differ by postoperative recovery pattern.
METHODS: We screened 411 consecutive HFS patients undergoing MVD; 344 who achieved complete remission lasting ≥ 30 days were included and grouped as early complete remission (≤7 days; n = 226) or delayed cure (>7 days; n = 118).Time zero was the first date of complete remission; recurrence was the event and others were censored at last follow-up.Cox regression was performed in the overall cohort and within subgroups, and recurrence-free survival was compared by Kaplan-Meier/log-rank.
RESULTS: Overall, no uniform independent factor associated with recurrence was identified; preoperative Cohen grade was not significantly associated with recurrence in the multivariable model(HR=1.61, 95%CI 0.96-2.70; P = 0.073). In subgroup analyses, preoperative Cohen grade was independently associated with recurrence in the early complete remission group (HR=2.09, 95%CI 1.07-4.07; P = 0.030), whereas AICA was independently associated with recurrence in delayed cure (HR=2.27, 95%CI 1.01-5.11; P = 0.047). Crude recurrence rates were similar between groups (23.01% vs 25.42%; P = 0.618), and recurrence-free survival did not differ significantly (log-rank P = 0.8969).
CONCLUSIONS: Although no definitive predictor of recurrence was identified in the pooled cohort, stratification by postoperative recovery pattern may help reveal subgroup-specific factors associated with recurrence among HFS patients who achieve complete remission after MVD.
METHODS: We screened 411 consecutive HFS patients undergoing MVD; 344 who achieved complete remission lasting ≥ 30 days were included and grouped as early complete remission (≤7 days; n = 226) or delayed cure (>7 days; n = 118).Time zero was the first date of complete remission; recurrence was the event and others were censored at last follow-up.Cox regression was performed in the overall cohort and within subgroups, and recurrence-free survival was compared by Kaplan-Meier/log-rank.
RESULTS: Overall, no uniform independent factor associated with recurrence was identified; preoperative Cohen grade was not significantly associated with recurrence in the multivariable model(HR=1.61, 95%CI 0.96-2.70; P = 0.073). In subgroup analyses, preoperative Cohen grade was independently associated with recurrence in the early complete remission group (HR=2.09, 95%CI 1.07-4.07; P = 0.030), whereas AICA was independently associated with recurrence in delayed cure (HR=2.27, 95%CI 1.01-5.11; P = 0.047). Crude recurrence rates were similar between groups (23.01% vs 25.42%; P = 0.618), and recurrence-free survival did not differ significantly (log-rank P = 0.8969).
CONCLUSIONS: Although no definitive predictor of recurrence was identified in the pooled cohort, stratification by postoperative recovery pattern may help reveal subgroup-specific factors associated with recurrence among HFS patients who achieve complete remission after MVD.