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Updated: Jul 6, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
How I do it: sling transposition technique with biopatch and aneurysm clip for hemifacial spasm
Sergio Corvino1, Vincenzo Seneca1, Giorgio Iaconetta2
1Department of Neurosurgery, Ospedale del Mare, 80147, Naples, Italy.
Background:
Microvascular decompression (MVD) represents the only definitive and non-ablative treatment for hemifacial spasm (HS). Teflon is the most used interposing material because considered inert; nevertheless, it is not free from complications.
Method:
We discuss and illustrate our method to resolve the neurovascular conflict accounting for HS through a sling transposition technique using aneurysm clip and biopatch in carefully selected cases.
Conclusion:
Several MVD procedures, including interposing and transposing techniques, have been proposed for HS, mainly selected according to surgeon's preference. We consider the described technique a definitive treatment, safe, not associated to pain recurrence and without needing revision surgery.
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