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Updated: Jun 20, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
[Microvascular decompression for hemifacial spasm. Ten years of experience]
Rogelio Revuelta-Gutiérrez1, Lourdes Olivia Vales-Hidalgo, Emiliano Arvizu-Saldaña
1Servicio de Neurocirugía del Instituto Nacional de Neurología y Neurocirugía, Manuel Velasco Suárez, México, D.F.
Introduction:
Hemifacial spasm characterized by involuntary paroxistic contractions of the face is more frequent on left side and in females. Evolution is progressive and in a few cases may disappear. Management includes medical treatment, botulinum toxin, and microvascular decompression of the nerve.
Material And Methods:
We present the results of 116 microvascular decompressions performed in 88 patients over 10 years.
Results:
All patients had previous medical treatment. All patients were operated on with microsurgical technique by asterional craniotomy. Vascular compression was present in all cases with one exception. Follow-up was from 1 month to 133 months. Were achieved excellent results in 70.45% of cases after first operation, good results in 9.09%, and poor results in 20.45% of patients. Long-term results were excellent in 81.82%, good in 6.82%, and poor in 11.36% of patients. Hypoacusia and transitory facial palsy were the main complications.
Discussion:
Hemifacial spasm is a painless but disabling entity. Medical treatment is effective in a limited fashion. Injection of botulinum toxin has good response but benefit is transitory. Microvascular decompression is treatment of choice because it is minimally invasive, not destructive, requires minimum technical support, and yields best long-term results.
