How I do it: combined interposition-transposition technique for microvascular decompression in primary hemifacial...

Area of Science:

• Neurosurgery
• Vascular Surgery

Background:

• Primary hemifacial spasm (HFS) is often treated with microvascular decompression (MVD).
• Existing MVD techniques include interposition (using spacers) and transposition (suturing the offending vessel).
• Transposition using self-adhesive materials has shown promising results in literature.

Purpose of the Study:

• To describe a combined surgical technique for MVD in HFS treatment.
• To present a novel approach utilizing autologous muscle and Tachosil®.

Main Methods:

• A combined surgical technique integrating interposition and transposition MVD is detailed.
• The procedure involves using autologous muscle and Tachosil® as graft materials.
• Surgical principles are elucidated step-by-step and supported by video demonstration.

Main Results:

• The described combined technique is effective in treating HFS.
• This approach is particularly beneficial for cases with large offending arteries where interposition alone may be insufficient.

Conclusions:

• The combined interposition and transposition MVD technique is an effective treatment for HFS.
• This method provides a viable solution for complex HFS cases, especially those involving significant vascular compression.