Improvement of Quality of Life in Patients with Hemifacial Spasm After Microvascular Decompression: A Prospective Study.

Abstract

Although not life threatening, hemifacial spasm (HFS) can be disabling and significantly affect quality of life (QOL). The aim of this study was to assess the major factors affecting the QOL and further to investigate the impact of microvascular decompression (MVD) on QOL in patients with HFS. Patients with HFS who underwent MVD in our department between 2013 and 2014 were included in this study. The validated, disease-specific questionnaire (HFS-30) was used to evaluate the QOL in patients with HFS before surgery and 1 year after MVD. The clinical data of these patients were collected prospectively and statistically analyzed. A total of 116 consecutive patients were enrolled in this study, including 69 women and 47 men, with a mean age of 43.3 ± 7.8 years. The global QOL was significantly impaired in patients with HFS. There was a positive correlation of severity of HFS with patient's QOL both in physical and mental health domains (r = 0.34, P = 0.02; r = 0.46, P = 0.03). Patients with a higher educational level tended to have a worse QOL in the mental health domain (r = 0.43, P = 0.02). Seventy-nine patients (68.1%) were spasm free immediately postoperatively, 106 (91.4%) were spasm free at 1-year follow-up. There were significant improvements across all subscales of the HFS-30 questionnaire between preoperative and postoperative responses, and 84.5% of patients experienced significant improvement in QOL after MVD. HFS affects QOL both physically and mentally. Patients with severe HFS symptoms or a higher educational level are at higher risk of worse QOL. MVD not only provides high spasm-relief rate but also leads to significantly higher QOL after surgery.