Abstract
We describe the approaches and techniques for microvascular decompression (MVD) for hemifacial spasm (HFS), focusing particularly on the lateral suboccipital infrafloccular approach. The lateral suboccipital infrafloccular approach for HFS differs completely from the approach for trigeminal neuralgia, although both approaches are termed as lateral suboccipital approach (LSA) [4, 8–10, 13–15]. The root exit zone (REZ) of cranial nerve (CN) VII or a nearby area is usually responsible for vascular compression-related HFS; therefore, we recommend the lateral suboccipital infrafloccular approach, in which REZ of CN VII is approached through the space between the origin of CN IX and the flocculus and choroid plexus protruding the foramen of Luschka from the inferior side [4, 7, 10, 13–15]. This approach can be used not only for MVD for HFS but also for other surgeries around the supraolivary fossette such as acoustic schwannoma surgery or pontomedullary tumor surgery.
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References
Fukushima T (1984) Results of posterior fossa microvascular decompression in the management of hemifacial spasm. Facial N Res Jpn 4:9–14 (in Japanese)
Funaki T, Matsushima T, Masuoka J, Nakahara Y, Takase Y, Kawashima M (2010) Adhesion of rhomboid lip to lower cranial nerves as special consideration in microvascular decompression for hemifacial spasm: Report of two cases. Surg Neurol Int 1:71
Hanakita J, Kondo A (1988) Serious complications of microvascular decompression operations for trigeminal neuralgia and hemifacial spasm. Neurosurgery 22:348–352
Hitotsumatsu T, Matsushima T, Inoue T (2003) Microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: three surgical approach variations: technical note. Neurosurgery 53:1436–1441
Martin RG, Grant JL, Peace D (1980) Microsurgical relationships of the anterior inferior cerebellar artery and the facial-vestibulocochlear nerve complex. Neurosurgery 6:483–507
Masuoka J, Matsushima T, Kawashima M, Nakahara Y, Funaki T, Mineta T (2011) Stitched sling retraction technique for microvascular decompression: procedures and techniques based on an anatomical viewpoint. Neurosurg Rev 34(3):373–379, discussion: 379–380
Matsushima T (2006) Microsurgical Anatomy and Surgery of the Posterior Fossa. SciMed Publications Inc, Tokyo (in Japanese)
Matsushima T, Fukui M, Suzuki S, Rhoton AL Jr (1989) The microsurgical anatomy of the infratentorial lateral supracerebellar approach to the trigeminal nerve for tic douloureux. Neurosurgery 24:890–895
Matsushima T, Fukui M, Yamashita M (1987) Microsurgical neurovascular decompression for trigeminal neuralgia. Special reference to Infratentorial lateral supracerebellar approach. Neurol Surg 15:1047–1054 (in Japanese)
Matsushima T, Hitotsumatsu T, Inamura T, Natori Y, Inoue T, Fukui M (2001) Pitfalls associated with microvascular decompression for hemifacial spasm and their overcome. Jpn J Neurosurg (Tokyo) 10:164–172 (in Japanese)
Matsushima T, Inoue T, Fukui M (1990) Arteries in contact with the cisternal portion of the facial nerve in autopsy cases: Microsurgical anatomy for neurovascular decompression surgery of hemifacial spasm. Surg Neurol 34:87–93
Matsushima T, Inoue T, Natori Y, Fukui M, Oliveira ED, Rhoton AL Jr (1992) Microsurgical anatomy of the region near the porus acusticus internus. Special reference to arteries around the facial and acoustic nerves bundle. Neurol Surg 20:409–415 (in Japanese)
Matsushima T, Inoue T, Natori Y, Fukui M, Rhoton AL Jr (1994) Microsurgical anatomy of the cerebellopontine angle, Surgical Anatomy for Microneurosurgery VI. SciMed Publications Inc, Tokyo, pp 134–145 (in Japanese)
Matsushima T, Inoue T, Suzuki S, Fujii K, Fukui M, Rhoton AL Jr (1992) Microsurgical anatomy of the cranial nerves and vessels in the cerebellopontine angle. Special reference to variation in the microvascular decompression, trigeminal neuralgia and hemifacial spasm, Surgical Anatomy for Microneurosurgery IV. SciMed Publications Inc, Tokyo, pp 45–55 (in Japanese)
Matsushima T, Katsuta T, Natori Y, Fukui M (1997) Microsurgical Anatomy of the cerebellopontine angle. Special reference to variations in the lateral suboccipital approach, Surgical Anatomy for Microneurosurgery IX. SciMed Publications Inc, Tokyo, pp 103–110 (in Japanese)
Matsushima T, Kawashima M, Inoue K, Matsushima K, Miki K (2014) Exposure of wide cerebellomedullary cisterns for vascular lesion surgeries in cerebellomedullary cisterns: Opening of unilateral cerebellomedullary fissures combined with lateral foramen magnum approach. World Neurosurg. doi: 10.1016/j.wneu.2014.04.064
Matsushima T, Rhoton AL Jr (2004) Vascular and MRI anatomy for the microvascular decompression surgeries, Surgical Anatomy for Microneurosurgery XVI. SciMed Publications Inc, Tokyo, pp 143–150 (in Japanese)
Matsushima T, Rhoton AL Jr, Oliveria ED, Peace D (1983) Microsurgical anatomy of the veins of the posterior fossa. J Neurosurg 59:63–105
Miyazono M, Inoue T, Matsushima T (2003) A surgical case of hemifacial spasm caused by a tortuous, enlarged, and calcified vertebral artery. Neurol Surg 31:437–441 (in Japanese)
Nagahiro S, Takada A, Matsukado Y, Ushio Y (1991) Microvascular decompression for hemifacial spasm. J Neurosurg 75:388–392
Nakahara Y, Matsushima T, Hiraishi T, Takao T, Funaki T, Masuoka J, Kawashima M (2013) Importance of awareness of the rhomboid lip in microvascular decompression surgery for hemifacial spasm. J Neurosurg. 119:1038–1042. doi:10.3171/2013.4JNS121546
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Matsushima, T. (2015). Microvascular Decompression Surgery for Hemifacial Spasm: The Lateral Suboccipital Infrafloccular Approach. In: Microsurgical Anatomy and Surgery of the Posterior Cranial Fossa. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54183-7_12
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DOI: https://doi.org/10.1007/978-4-431-54183-7_12
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