Efficacy and safety of microvascular decompression for hemifacial spasm: Endoscopy vs microscopy

Microvascular decompression (MVD) is the most effective approach to treating hemifacial spasm (HFS). We aimed to evaluate the clinical efficacy and safety of endoscopic MVD (E-MVD) for treating HFS versus microscopic MVD (M-MVD). We analyzed consecutive 189 HFS individuals who underwent either an E-MVD or M-MVD procedure (January 2016-June 2024). The efficacy was assessed by operation time, learning curve, and clinical efficacy. Safety was assessed by the duration of dizziness and postoperative complications. We found none of the groups showed significantly different clinical efficacy (P = .709) after 1 year of follow-up. No statistical difference was presented in postoperative complications between both groups. The E-MVD group arrived at the plateau period of the learning curve at a quicker pace. The incidence of dizziness postoperatively in the E-MVD group is less than that in the M-MVD group (P = .037). E-MVD has the same clinical efficacy as M-MVD and reduces the learning curve. Further investigation needs to be conducted, preferably in a randomized controlled setting.