A Comparative Study of Traditional and Synchronous Video Lateral Spread Response Monitoring in Predicting Long-Term Hemifacial Spasm Relief After Microvascular Decompression Surgery.

Background and objectives: The study aims to investigate the significance of using synchronous video monitoring for lateral spread response (LSR) during microvascular decompression (MVD) surgery for hemifacial spasm.

Methods: A retrospective analysis was conducted on data from 75 patients with primary hemifacial spasm who underwent MVD treatment at our hospital between September 2018 and June 2019. Traditional intraoperative LSR monitoring and synchronous video LSR monitoring were compared to predict postoperative spasm relief outcomes at 1 week, 1 month, 6 months, 1 year, and 5 years, alongside actual clinical observations. Traditional LSR monitoring showed moderate agreement with actual clinical observations at 1 week postoperatively (K1w = 0.433;, fair agreement at 1 month, 6 months, and 1 year (K1m = 0.386, K6m = 0.295, K1y = 0.225); and poor agreement at 3 years and 5 years (K3y = 0.182, K5y = 0.138).

Results: In comparison, synchronous video LSR monitoring demonstrated moderate agreement at 1 week, 1 month, 6 months, and 1 year (K1w = 0.533, K1m = 0.535, K6m = 0.574, K1y = 0.182) and fair agreement at 3 years and 5 years (K3y = 0.321, K5y = 0.217). Patients with intraoperative LSR changes experienced earlier symptom relief within 6 months compared with those without LSR changes. The overall relief rates at 1 year, 3 years, and 5 years were 93.33%, 94.67%, and 96.00%, respectively. The delayed resolution rates were 70.59%, 76.47%, and 82.35% at 1 year, 3 years, and 5 years, respectively.

Conclusion: The application of synchronous video LSR monitoring facilitates the assessment of patients' clinical prognosis within 6 months postoperatively, thereby guiding surgical interventions. In predicting the consistency of post-MVD spasm relief, synchronous video LSR monitoring outperforms traditional LSR monitoring methods.