Lateral basal approach with a supine, no-retractor method for microvascular decompression for hemifacial spasm

Area of Science:

• Neurosurgery
• Neurology
• Surgical Innovation

Background:

• Hemifacial spasm is a neurological disorder characterized by involuntary facial muscle contractions.
• Microvascular decompression is a primary surgical treatment for hemifacial spasm.
• Existing surgical approaches often require complex patient positioning and cerebellar retraction.

Purpose of the Study:

• To present a unique and simplified surgical procedure for microvascular decompression in hemifacial spasm.
• To highlight the advantages of the subfloccular approach for accessing the facial nerve root.

Main Methods:

• The described technique utilizes a supine patient position, eliminating the need for lateral or park-bench positioning.
• A subfloccular approach through a small occipital cranial window is employed.
• This method allows access to all facial nerve root segments without requiring cerebellar retraction.

Main Results:

• The subfloccular approach facilitates direct visualization and access to the facial nerve root.
• The technique avoids the need for cerebellar retraction, potentially reducing associated risks.
• The procedure allows for decompression of any segment of the facial nerve root.

Conclusions:

• The presented surgical approach is considered ideal for safe and precise microvascular decompression in hemifacial spasm.
• This technique offers a simplified and potentially less invasive alternative to traditional methods.