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Updated: Jun 26, 2026
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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
How I do it: Implant-free transposition technique for microvascular decompression in hemifacial spasm
Melanie Kristt1,2, Raymond F Sekula3
1Department of Neurological Surgery, Columbia University Irving Medical Center, New York Presbyterian Hospital, 710 W 168th St., 4th Floor, New York, NY, 10032, USA.
Acta Neurochirurgica
|June 24, 2026
Summary
Microvascular decompression (MVD) using vessel transposition with TachoSil® is a safe and effective treatment for hemifacial spasm (HFS). This surgical technique offers potential advantages for patients with facial nerve compression.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Hemifacial spasm (HFS) is frequently caused by arterial compression of the facial nerve (CNVII).
- Microvascular decompression (MVD) is a primary surgical treatment for HFS with high success rates.
Purpose of the Study:
- To describe a surgical technique for MVD in HFS using vessel transposition with TachoSil®.
- To evaluate the safety and efficacy of this approach.
Main Methods:
- Step-by-step description of MVD using vessel transposition.
- Utilized TachoSil® as a surgical adjunct.
- Supported by an illustrative video demonstration.
Main Results:
- The described technique is safe and effective in experienced hands.
- Achieved spasm freedom in approximately 90% of patients (general MVD outcome).
Conclusions:
- Vessel transposition with TachoSil® is a viable MVD technique for HFS.
- This method offers potential advantages over traditional materials.
- Appropriate patient selection is key for successful outcomes.
