The Current Status of Microvascular Decompression for the Treatment of Hemifacial Spasm in Japan: An Analysis of 2907 Patients Using the Japanese Diagnosis Procedure Combination Database

• Published in: Neurologia medico-chirurgica Vol. 57; no. 4; pp. 184 - 190
• Main Authors: MIZOBUCHI, Yoshifumi, MURAMATSU, Keiji, OHTANI, Makoto, SATOMI, Junichiro, FUSHIMI, Kiyohide, MATSUDA, Shinya, NAGAHIRO, Shinji
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 2017; THE JAPAN NEUROSURGICAL SOCIETY; Japan Science and Technology Agency
• Subjects: Adult; Aged; Aged, 80 and over; Data processing; Databases, Factual; Decompression; Diagnosis; Diagnosis Procedure Combination; Female; hemifacial spasm; Hemifacial Spasm - epidemiology; Hemifacial Spasm - surgery; Humans; Japan - epidemiology; Male; microvascular decompression; Microvascular Decompression Surgery - statistics & numerical data; Microvasculature; Middle Aged; Original; Patient Selection; Patients; Practice Patterns, Physicians' - statistics & numerical data; Retrospective Studies; Young Adult; Japan; microvascular decompression; hemifacial spasm; Diagnosis Procedure Combination
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.oa.2016-0237

Microvascular decompression (MVD) is widely used as a safe and effective treatment for hemifacial spasm (HFS). However, the extent of application of this therapeutic method and its outcomes in Japan are currently unclear. To address these questions, we analyzed the utilization of MVD for the treatment of HFS during the 33- month period from July 2010 to March 2013. We conducted an analysis on data contained in the Diagnosis Procedure Combination database in Japan. This analysis showed that MVD was used for the treatment of HFS in 2907 cases (men, 916; women, 1991) with 2.2 times more women treated than men. MVD for HFS was most frequently performed in women aged 50 to 69 years; however, most men were aged between 40 and 59 years at the time of the procedure. The numbers of procedures performed per 100,000 population/year were 0.83 overall in Japan, with the numbers larger in prefectures with larger populations. Regarding discharge outcomes, the mortality rate was 0.1%. The mean length of hospital stay in patients undergoing MVD for HFS was 14.7 days. This analysis provides preliminary information regarding the trends in the performance of MVD for the treatment of HFS in Japan. Further studies on other registries that contain data obtained by standardized assessment methods and that include long-term outcomes and postoperative complications are required.