Degeneration of urethane sponge prosthesis as source of late recurrence of hemifacial spasm: A case report

Abstract

We describe a case of second microvascular decompression (MVD) 30 years after the first operation. A 54-year-old male first developed left hemifacial spasm (HFS) at age 23 years. He underwent MVD surgery using urethane sponge as prosthesis. He had no recurrence for approximately 20 years. He suffered relapse at age 42 years. Second MVD was carried out. Intraoperative findings demonstrated degenerated urethane sponge around the left glossopharyngeal nerve. The abnormal muscle response wave immediately disappeared as the sponge was removed. The patient has experienced no spasm since the surgery. Previously reported study found 10.8 % of patients who underwent initial MVD experienced recurrence at mean 51.1 months. We speculate that degeneration of the sponge which resulted recurrence of HFS in our case.

Keywords

• Hemifacial spasm
• Long-term follow up
• Microvascular decompression
• Recurrence