Hypertension and Diabetes are Associated With Clinical Characteristics in Patients Undergoing Microvascular Decompression for Hemifacial Spasm

Hypertension and Diabetes are Associated With Clinical Characteristics in Patients Undergoing Microvascular Decompression for Hemifacial Spasm: Objectives:

The aim of the present study is to investigate effect of hypertension and diabetes on neuroelectrophysiology, outcomes and complications in patients with hemifacial spasm (HFS) treated by microvascular decompression (MVD).

Methods:

From June 2014 to December 2016, 476 consecutive HFS patients who had undergone MVD were divided into 2 groups according to the presence or absence of comorbidities: diabetic group (n = 26) versus non-diabetic group (n = 450), and hypertensive group (n = 141) versus normotensive group (n = 335). Relevant patient data, including preoperative and postoperative neuroelectrophysiology, operative findings, outcome of MVD and complications, were collected and analyzed retrospectively over the 2-year follow-up period. The impact of hypertension and diabetes on the clinical features of HFS patients was investigated by using logistic regression models.

Results:

Brainstem auditory evoked potential (BAEP), postoperative prognosis and abnormal muscle response (AMR) were not different between any of the 2 groups. Preoperative positive AMR occurred more frequently in the nondiabetic group than diabetic group [OR = 0.202, P = 0.004], whereas hypertension was not independently predictive for neuroelectrophysiology in patients with HFS. Adjusted multivariate analysis indicated that hypertension was the only clinical factor associated with MVD-related complications [OR = 0.482, P = 0.007] and hearing impairment [OR = 0.28, P = 0.004] after various potential confounders were taken into account, whereas diabetes was not predictive for postoperative complications.

Conclusions:

Diabetes is associated with low positive rate of preoperative AMR, thus weakening the predictive role of AMR for successful MVD. Hypertension may be an independent risk factor for hearing impairment after MVD.

Address correspondence and reprint requests to Xiaoqiang Wang, MD, Neurosurgery Department, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1665 Kongjiang Road, Yangpu District, Shanghai 200092, China; E-mail: wangxiaoqiang@xinhuamed.com.cn

Received 11 June, 2019

Accepted 14 August, 2019

LM and WZ contributed equally to this work and are co-first authors.

This work was supported by the Science and Technology Committee of Shanghai Municipal [13ZR1426800].

The authors report no conflicts of interest.

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© 2019 by Mutaz B. Habal, MD.