Transforming Lives: Evaluating Quality of Life Enhancement in Hemifacial Spasm Patients through Microvascular Decompression - A HFS-5 Grading Questionnaire Study

Abstract Background Hemifacial spasm (HFS), a neuromuscular disorder affecting facial muscles, is commonly treated with microvascular decompression (MVD). This study aims to validate the HFS-5 grading questionnaire in assessing health-related quality of life improvements post-MVD. Methods A retrospective analysis was conducted on 147 out of 239 HFS patients treated with MVD from January 2018 to December 2021. The HFS-5 questionnaire was used to evaluate the patients' health-related quality of life before and after surgery. Statistical analyses included paired sample t-tests, Intraclass Correlation Coefficient (ICC), Cronbach’s α, and Bland-Altman plot. Results The study group comprised 34.7% males and 65.3% females, with an average age of 55.5 years. Most patients exhibited grade 3 or 4 severity. Severity of HFS was reduced significantly post-treatment, with the majority of patients (81.6%) reporting complete or significant symptom relief. The AICA was the most common compressing vessel identified. Statistically significant improvements were observed in all five items of the HFS-5 questionnaire after the surgery. The questionnaire demonstrated high reliability and validity, with ICC values between 0.799–0.851 and Cronbach’s α ranging from 0.745–0.776. A significant correlation was found between preoperative scores and HFS severity, as well as between postoperative score reduction and improvement in severity. Furthermore, a strong agreement between the HFS-5 and HFS-8 evaluation methods was observed, affirming the consistency and reliability of these tools in assessing the quality of life in HFS patients. Conclusion MVD significantly enhances the quality of life for patients suffering from HFS, as evidenced by the improved HFS-5 scores post-surgery. The reliability and consistency of the HFS-5 questionnaire make it an effective tool for evaluating patient outcomes following MVD. These findings support the continued use of MVD as a treatment option for HFS, emphasizing its role in improving patient well-being and functionality.