Supine No-Retractor Method in Microvascular Decompression for Hemifacial Spasm: Results of 100 Consecutive Operations

Area of Science:

• Neurosurgery
• Neurology

Background:

• Microvascular decompression (MVD) for hemifacial spasm (HFS) traditionally uses complex patient positioning.
• Cerebellar retraction during MVD can lead to surgical complications.

Purpose of the Study:

• To introduce a novel, simplified surgical approach for MVD in HFS patients.
• To evaluate the efficacy and safety of this new technique.

Main Methods:

• A supine positioning technique was employed for MVD in 100 primary HFS patients.
• A subfloccular approach through a small occipital cranial window was utilized, avoiding spatula use.
• Surgery was performed by a single surgeon between August 2012 and April 2014.

Main Results:

• 94% of patients experienced complete symptom resolution or significant improvement.
• No new neurological deficits, including hearing impairment, were observed post-surgery.
• Multiple offending vessels were identified in 47 cases.

Conclusions:

• The supine subfloccular approach offers a safe and effective alternative for MVD in HFS.
• This method simplifies the surgical procedure and potentially reduces complications associated with traditional positioning.