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Updated: Jun 5, 2025
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
[Microvascular decompression in hemifacial spasm: functional outcome]
Mauro Suárez1, Ernesto Ardisana1, Juan F Villalonga1
1Laboratorio de Innovaciones Neuroquirúrgicas de Tucumán (LINT), Tucumán, Argentina.
Introduction:
Hemifacial spasm (HFS) is a rare condition, characterized by unilateral, paroxysmal and involuntary contraction of the muscles innervated by the facial nerve (FN). The most common cause is a vascular conflict in the exit zone of the FN. The objective of this work is to demonstrate the efficacy and safety of neurovascular decompression (NVD).
Materials And Methods:
Retrospective analytical study, patients operated on for NVD due to HFS (n: 48), from June 2005 to December 2023, using a retrosigmoid approach and clinical-radiological follow-up, whose intraoperative recording was with a 2D or 3D video system. Age, gender, time of evolution, side of the condition, use of botulinum toxin, intraoperative findings, postsurgical results and complications were evaluated.
Results:
The average age was 50 years, with 60% women. The right side was affected in 23 cases. The vessel most identified as causing the neurovascular conflict was the anterior inferior cerebellar artery in 48% of the cases. The clinical response was complete (disappearance of HFS) in 41 patients (85%), partial in 5 cases and null in 2 cases. Complications included transient deficits in 11 cases and permanent deficits in 2 cases.
Discussion:
Most of our patients with HFS (85%) obtained a total improvement, along with a low rate of permanent morbidity (4%) and no cases of mortality. NVD should be considered as the first line of treatment in patients with primary HFS with evidence of neurovascular conflict on MRI.
