Microvascular decompression surgery for hemifacial spasm

Objective To investigate operative efficacy, surgical complication rate and surgical strategy of microvascular decompression (MVD) for hemifacial spasm (HFS). Methods The clinical data of 46 patients with HFS were retrospectively analysed. All patients underwent MVD. Results During operation, it was found that the facial nerve root exit zone (RExZ) was compressed by arterial vessels, namely anterior inferior cerebellar artery (AICA) in 24 cases (52.17%), posterior inferior cerebellar artery (PICA) in 14 cases (30.43%), vertebral artery and small artery in 7 cases (15.22%), and vertebral artery in one case (2.18% ). Symptoms in 38 patients were completely remitted immediately after surgery, and symptoms of 8 cases were reduced significantly. The main complications included dizziness and tinnitus in 9 cases, hearing loss in 5 cases, cerebrospinal fluid leakage in one case, and infection in 2 cases. No patient died during operation. Conclusion Microvascular decompression is the first choice for treating idiopathic hemifacial spasm. Skilled microsurgical techniques, and identification and complete decompression of the responsible artery are the key to ensure success in microvascular decompression. DOI：10.3969/j.issn.1672-6731.2010.05.013