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How I do it: endoscopic microvascular decompression for hemifacial spasm associated with the vertebral artery.
Acta Neurochirurgica 2018 January
BACKGROUND: Microvascular decompression (MVD) of hemifacial spasm (HFS) associated with the vertebral artery (VA) shows higher rates of incomplete cure and complications compared to non-VA-related HFS.
METHOD: Purely endoscopic MVD for VA-associated HFS via a retrosigmoid keyhole was performed. Neurovascular conflicts by a directly offending artery and VA around the root exit zone of the facial nerve were clearly demonstrated under 30° endoscopic view without significant cerebellar retraction. The VA and directly offending artery were safely transposed with preservation of perforators under excellent view.
CONCLUSION: Endoscopic MVD offers reliable decompression for VA-associated HFS with minimal invasiveness.
METHOD: Purely endoscopic MVD for VA-associated HFS via a retrosigmoid keyhole was performed. Neurovascular conflicts by a directly offending artery and VA around the root exit zone of the facial nerve were clearly demonstrated under 30° endoscopic view without significant cerebellar retraction. The VA and directly offending artery were safely transposed with preservation of perforators under excellent view.
CONCLUSION: Endoscopic MVD offers reliable decompression for VA-associated HFS with minimal invasiveness.
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