Fully endoscopic microvascular decompression for hemifacial spasm: a systematic review.

Area of Science:

• Neurosurgery
• Minimally Invasive Techniques
• Neurology

Background:

• Hemifacial spasm (HFS) is a neurological disorder causing involuntary facial twitching due to facial nerve compression.
• Traditional microvascular decompression (MVD) is effective but carries surgical risks.
• Fully endoscopic MVD (E-MVD) presents a potentially safer and more efficacious approach.

Purpose of the Study:

• To systematically review and evaluate the safety and efficacy of fully endoscopic microvascular decompression (E-MVD) for treating hemifacial spasm (HFS).

Main Methods:

• A systematic literature search was conducted across PubMed/MEDLINE, Embase, and Cochrane Library following PRISMA guidelines.
• Eligible studies were assessed for quality using the NIH tool, with data extracted independently.
• Included 408 patients, analyzing demographics, surgical findings, complications, and long-term outcomes.

Main Results:

• The study included 408 patients (68% female, mean age 52.4 years) with a mean symptom duration of 4.5 years.
• The most common cause was anterior inferior cerebellar artery (AICA) compression (48.1%).
• Early complications occurred in 13.6% (transient facial palsy 6.8%, hearing impairment 4%), with high resolution rates.

Conclusions:

• Fully endoscopic MVD demonstrates promising efficacy for hemifacial spasm, achieving 93.3% symptom resolution.
• The technique offers advantages in safety and effectiveness, improving patient quality of life.
• Continued advancements and careful surgical technique are crucial for optimal outcomes in E-MVD for HFS.