Construction of a risk model for delayed healing in patients with hemifacial spasm after microvascular decompression surgery&nbsp; using a nomogram

doi:10.13418/j.issn.1001-165x.2025.6.15

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Chinese Journal of Clinical Anatomy ›› 2025, Vol. 43 ›› Issue (6) : 717-723. DOI: 10.13418/j.issn.1001-165x.2025.6.15

Construction of a risk model for delayed healing in patients with hemifacial spasm after microvascular decompression surgery using a nomogram

Yang Chunchun, Pan Didi, Hou Xuelei, Zhang Wang

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Abstract

Objective To analyze the influencing factors of delayed cure after microvascular decompression (MVD) in patients with hemifacial spasm and to construct and validate a nomogram risk model. Methods A total of 108 patients with hemifacial spasm admitted to our hospital from August 2022 to November 2024 were selected. All patients underwent MVD. They were followed up for 6 months after surgery and divided into the observation group and the control group based on whether delayed cure occurred after MVD. The influencing factors of delayed cure after MVD in patients with hemifacial spasm were analyzed, and a nomogram risk model was constructed and validated. Results After follow-up, no patients were lost to follow-up. There was 1 recurrence, 1 ineffective case, 2 partial remissions, 3 significant remissions, 21 delayed cures, and 80 immediate cures. The observation group had a longer medical history than the control group (P<0.05). The proportion of severe vascular compression during surgery, grade IV hemifacial spasm severity before surgery, and undiminished abnormal muscle response (AMR) monitoring in the observation group was higher than those in the control group (P<0.05). The proportion of patients with nerve root indentation in the observation group was lower than in the control group (P<0.05). Long medical history, severe vascular compression during surgery, grade IV hemifacial spasm severity before surgery, and undiminished AMR monitoring were independent risk factors for delayed cure after MVD in patients with hemifacial spasm (P<0.05). Nerve root indentation was a protective factor for delayed cure after MVD in patients with hemifacial spasm (P<0.05). The nomogram model predicted delayed cure after MVD in patients with hemifacial spasm with a sensitivity of 90.48%, a specificity of 83.75%, and an AUC of 0.929. Conclusions Long medical history, severe vascular compression during surgery, grade IV hemifacial spasm severity before surgery, undiminished AMR monitoring, and nerve root indentation are related to delayed cure after MVD in patients with hemifacial spasm. Constructing a nomogram risk model is helpful for early identification of the risk of delayed cure after MVD.

Key words

Hemifacial spasm; / / Microvascular decompression; / / Delayed cure; / / Influencing factors / Prediction model

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Yang Chunchun, Pan Didi, Hou Xuelei, Zhang Wang. Construction of a risk model for delayed healing in patients with hemifacial spasm after microvascular decompression surgery using a nomogram[J]. Chinese Journal of Clinical Anatomy. 2025, 43(6): 717-723 https://doi.org/10.13418/j.issn.1001-165x.2025.6.15

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