Delayed facial palsy after microvascular decompression for hemifacial spasm: multivariate Logistic regression analysis of influencing factors

Abstract

Objective To explore the influencing factors for delayed facial palsy after microvascular decompression for hemifacial spasm. Methods We retrospectively analyzed 306 cases of hemifacial spasm undergoing microvascular decompression. The cases were divided into facial paralysis group and control group according to whether postoperative delayed facial paralysis occurred, comparing gender, age, disease duration, hypertension, diabetes, old cerebral infarction, spasm position, pre⁃operation Cohen grade, number of responsible vessels, severe indentation between two groups. Single factor and multivariate stepwise Logistic regression analysis were used to determine the risk factors for delayed facial palsy after microvascular decompression. Results Delayed facial palsy occurred in 21 cases (6.86%). House brackmann (H⁃B) grade Ⅲ in 2 cases, Ⅳ in 17 cases, Ⅴ in 2 cases. Multivariate stepwise Logistic regression analysis showed that disease duration (OR = 1.130, 95%CI: 1.004-1.271; P = 0.042) and severe indentation (OR = 0.167, 95%CI: 0.056-0.495; P = 0.001) were the risk factors for delayed facial palsy after microvascular decompression. During 0.50-5.00 years' follow ⁃ up, 19 patients with delayed faoial palsy recovered completely, and 2 patients recovered to H⁃B grade Ⅱ. Conclusions Severe indentation and disease duration were risk factors for delayed facial palsy after microvascular decompression. Delayed facial palsy is generally self⁃healing with a good prognosis.

DOI：10.3969/j.issn.1672⁃6731.2020.12.012