@phdthesis{ElDamaty2016,
  author    = {Ahmed El Damaty},
  title     = {The Value of Lateral Spread Response Monitoring in Predicting the Clinical Outcome after Microvascular Decompression in Hemifacial Spasm: A Prospective Study on 100 patients.},
  journal    = {Die Bewertung der Lateral Spread Response Monitoring zur Vorhersage der klinischen Ergebnisse nach mikrovaskul{\"a}rer Dekompression in Spasmus hemifacialis; eine prospektive Studie von 100 Patienten.},
  url       = {https://nbn-resolving.org/urn:nbn:de:gbv:9-002673-2},
  year      = {2016},
  abstract  = {Background: Microvascular Decompression represents an effective treatment for hemifacial spasm. The use of lateral spread responses (LSRs) monitoring remains a useful intraoperative tool to ensure adequate decompression of the facial nerve. Objective: To assess the value of LSRs intraoperative monitoring as a prognostic indicator for the outcome of microvascular decompression in hemifacial spasm. Methods: Our study included 100 patients prospectively. The patients were classified into 4 groups whether LSRs were totally, partially, not relieved or not detected from the start. According to clinical outcome, the patients were classified into 4 groups depending on the clinical course after surgery and the residual symptoms if any. Then, correlations were made between LSRs events and treatment outcome to detect its reliability as a prognostic indicator. Results: LSRs were relieved totally in 56\% of the patients, partially relieved in 14\%, not relieved in 10\% and were not detected in 20\% of the patients from the start. HFS was relieved directly after operation in 62\% with clinical improvement of 90-100\%. 31\% described 50-90\% improvement over the next 3 months after surgery. Almost all of these 31\% (28 out of 31 patients) reported further clinical improvement of 90-100\% within one year after surgery. 3\% suffered from a relapse after a HFS-free period and 4\% reported minimal or no improvement describing 0-50\% of the preoperative state. The percentage of the satisfied patients with the clinical outcome who reported after one year a clinical improvement of 90-100\% was 90\%. Statistical analysis did not find a significant correlation between the relief of LSRs and clinical outcome. Conclusion: LSRs may only represent an intraoperative tool to guide for an adequate decompression but failed to represent a reliable prognostic indicator for treatment outcome.},
  language  = {en}
}