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How i do it: endoscopic transposition technique for hemifacial spasm caused by AICA compression
Wei Zhang1, Fuminari Komatsu2, Yoko Kato3
1Department of Neurosurgery, Yidu Central Hospital of Weifang, Shandong Second Medical University, 4138 Linglongshan Road, Qingzhoushi, Shandong Province, 262500, China.
Background:
Anterior inferior cerebellar artery (AICA) compression is a common cause of hemifacial spasm (HFS). Endoscopic-assisted microvascular decompression (eMVD) offers several advantages, including minimal invasiveness, wide viewing angles, and clear visualization.
Methods:
The surgical procedure was performed under a four-step endoscopic technique. Step 1: A 0° endoscope was used to dissect the cerebellopontine cistern and release cerebrospinal fluid for decompression. Step 2: A 30° endoscope was employed to dissect the arachnoid around the facial nerve and expose the root exit zone (REZ). Step 3: The AICA was identified, carefully dissected, and transposed away from the REZ. Step 4: Adequate decompression and hemostasis were confirmed.
Conclusion:
The four-step endoscopic approach can achieve effective decompression in cases of HFS caused by AICA compression, providing favorable surgical outcomes.
