Improved Quality of Life after Microvascular Decompression for Hemifacial Spasm

This study aimed to evaluate the effectiveness of microvascular decompression (MVD) in improving the quality of life (QoL) of patients with hemifacial spasm (HFS), focusing on both short- and long-term outcomes. When will patients with HFS benefit from MVD regarding QoL? A longitudinal, prospective cohort study was conducted, involving 135 patients who underwent MVD at a tertiary referral center between January 2019 and March 2023. Health-related quality of life (HR-QoL) was assessed using the SF-36 questionnaire administered at three intervals: before surgery, three months after surgery, and twelve months after surgery. Most patients reported complete resolution (63.4%) or at least 90% reduction (13.9%) of spasms after twelve months. Significant improvements were observed in the SF-36 scores, particularly in the domains of Mental Health and Social Functioning, from baseline to twelve months after surgery. Additionally, improvements in Mental Component Summary scores were statistically significant, suggesting substantial importance of patient-reported mental and emotional well-being. Permanent postoperative complications (hearing reduction/loss, mild hoarseness) were seen in 2.9%. The findings confirm that MVD provides significant and sustained improvements in HR-QoL in patients with HFS. The surgery not only alleviates physical symptoms but also contributes to substantial psychosocial recovery. These outcomes support MVD as a preferred treatment for HFS when a neurovascular conflict is suspected, advocating for its broader application in clinical practice. Continued follow-up and research are recommended to further document the procedure’s long-term effectiveness and safety. • 63.4% complete spasm resolution; 13.9% achieved ≥90% reduction at 12 months • Significant SF-36 improvements in Mental Health and Social Functioning domains • Statistically significant Mental Component Summary gains indicate psychosocial recovery • Only 2.9% permanent complications (hearing loss/reduction, mild hoarseness) • MVD demonstrates sustained effectiveness as preferred treatment for hemifacial spasm