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1.  Delayed Cranial Nerve Palsy after Microvascular Decompression for Hemifacial Spasm 
Objective
Microvascular decompression (MVD) for hemifacial spasm (HFS) is a safe and effective treatment with favorable outcomes. The purpose of this study was to evaluate the incidence of delayed cranirve ( VI, VII, and VIII ) palsy following MVD and its clinical courses.
Methods
Between January 1998 and December 2009, 1354 patients underwent MVD for HFS at our institution. Of them, 100 patients (7.4%) experienced delayed facial palsy (DFP), one developed sixth nerve palsy, and one patient had delayed hearing loss.
Results
DFP occurred between postoperative day number 2 and 23 (average 11 days). Ninety-two patients (92%) completely recovered; however, House-Brackmann grade II facial weakness remained in eight other patients (8%). The time to recovery averaged 64 days (range, 16 days to 9 months). Delayed isolated sixth nerve palsy recovered spontaneously without any medical or surgical treatment after 8 weeks, while delayed hearing loss did not improve.
Conclusion
Delayed cranial nerve (VI, VII, and VIII) palsies can occur following uncomplicated MVD for HFS. DFP is not an unusual complication after MVD, and prognosis is fairly good. Delayed sixth nerve palsy and delayed hearing loss are extremely rare complications after MVD for HFS. We should consider the possibility of development of these complications during the follow up for MVD.
doi:10.3340/jkns.2012.52.4.288
PMCID: PMC3488634  PMID: 23133714
Delayed facial palsy; Microvascular decompression; Delayed cranial palsy; Delayed hearing loss; Delayed abducens palsy
2.  Regrowing Synovial Chondromatosis in a Cervical Facet Joint with Radiculopathy 
Korean Journal of Spine  2012;9(3):253-256.
Synovial chondromatosis (SC) in the spine is rare. There are few reports of associated cervical radiculopathy and there has not been a case reported of regrowing cervical SC. Here we report a 21-year-old man with a SC of a cervical facet joint that extended into the intervertebral foramen and compressed the cervical nerve root. The same symptom developed three years following the first operation. Computed tomography (CT) scans and Magnetic resonance imaging (MRI) showed multiple calcified nodules anterior to the right facet joint of C6-7 that extended into the intervertebral foramen. A mass removal was performed just as in the previous operation with a subtotal facetectomy. When vertebral SC is suspected, complete removal involving the bone and synovium should be considered as the standard treatment option.
doi:10.14245/kjs.2012.9.3.253
PMCID: PMC4431012  PMID: 25983825
Cervical facet; Radiculopathy; Regrowing; Synovial Chondromatosis

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