Microvascular decompression for hemifacial spasm in patients >65 years of age: an analysis of outcomes and complications.

INTRODUCTION: Few data are available to quantify the risks and benefits of microvascular decompression (MVD) in elderly patients with hemifacial spasm. METHODS: Twenty-seven patients >65 years of age and 104 younger patients who underwent MVD for hemifacial spasm (HFS) over a 3-year period were analyzed retrospectively and compared. RESULTS: Twenty-six (96.3%) elderly patients and 93 of 104 (89.4%) young patients reported a spasm-free status at a mean follow-up of 26.5 months after MVD. No significant difference in spasm-free status was noted. Cranial nerve complications and other major complications were compared, with no significant differences observed. CONCLUSIONS: Although this study does not offer definitive inclusion or exclusion criteria or clearly establish the safety of MVD for HFS in the elderly, our experience suggests that many elderly patients with HFS can undergo MVD safely, with outcomes and risk profiles similar to those of younger patients.