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Surgical treatment of hemifacial spasm by microvascular decompression

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Summary

An outline of the clinical syndromes of hemifacial spasm (HFS), the history of surgical treatments for this condition and a detailed description of the authors’ preferred form of operative treatment is provided. Operative findings, results, and complications in HFS patients treated at the University of Pittsburgh, Presbyterian-University Hospital during the period between 1972 and 1993 is reviewed. It is concluded at this time that a retromastoid craniotomy and microvascular decompression (MVD), in experienced hands, is a safe and highly effective procedure to treat both forms of HFS.

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References

  1. Apfelbaum RI (1988) Surgical management of disorders of the lower cranial nerves. In: Schmidek HH, Sweet WH (eds) Operative neurosurgical techniques. Indications, methods, and results, vol. 2, Grune and Stratton, Orlando Florida, pp 1097–1109

    Google Scholar 

  2. Barker FG, Jannetta PJ, Bissonette DJ, Shields PT, Larkins MV, Jho HD (1995) Microvascular decompression for hemifacial spasm. J Neurosurg 82: 201–210

    Article  PubMed  Google Scholar 

  3. Campbell E, Keedy C (1947) HFS: A note on the etiology in two cases. J Neurosurg 4: 342–347

    Article  PubMed  CAS  Google Scholar 

  4. Digre K, Corbett JJ (1988) Hemifacial spasm: Differential diagnosis mechanism and treatment. In: Tolosa E (ed) Advances in neurology, vol. 39, Facial dyskinesia. Raven Press, New York, pp 151–176

    Google Scholar 

  5. Esslen E (1957) Der Spasmus facialis eine Parabiosserscheinung: Elektrophysiologische Untersuchungen zum Entstehungsmechanismus des Facialisspasmus. Dtsch Z Nervenheil 176: 149–172

    CAS  Google Scholar 

  6. Fisch U, Esslen E (1972) The surgical treatment of facial hyperkinesia. Arch Otolaryngol 95: 400–405

    PubMed  CAS  Google Scholar 

  7. Gardner WJ (1962) Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg 19: 947–957

    Article  PubMed  CAS  Google Scholar 

  8. Gardner WJ, Sava GA (1962) Hemifacial spasm–A reversible pathophysiologic state. J Neurosurg 19: 240–247

    Article  Google Scholar 

  9. Gowers R (1988) Manual of diseases of the nervous system. JA Churchill, London

    Google Scholar 

  10. Grundy BL (1983) Intraoperative monitoring of sensory evoked potentials. Anesthesiology 58: 72–87

    Article  PubMed  CAS  Google Scholar 

  11. Haines SJ, Torres F (1991) Intraoperative monitoring of the facial nerve during decompressive surgery for hemifacial spasm. J Neurosurg 74: 254–257

    Article  PubMed  CAS  Google Scholar 

  12. Jannetta PJ (1970) Microsurgical exploration and decompression of the facial nerve in hemifacial spasm. Curr Top Surg Res 2: 217–220

    Google Scholar 

  13. Jannetta PJ (1977) Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction, and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients. Acta Neurochir (Wien) 20: 145–154

    CAS  Google Scholar 

  14. Jannetta PJ (1980) Neurovascular compression in cranial nerve and systemic disease. Ann Surg 192: 518–525

    Article  PubMed  CAS  Google Scholar 

  15. Jannetta PJ (1981) Hemifacial spasm. In: Samii M, Jannetta PJ (eds) The cranial nerves. Springer, Heidelberg, pp 484–493

    Google Scholar 

  16. Jannetta PJ (1984) Hemifacial spasm caused by a venule: Case report. Neurosurgery 14: 89–92

    Article  PubMed  CAS  Google Scholar 

  17. Jannetta PJ (1985) Neurovascular contact in hemifacial spasm. In: Portmann M (ed) Facial nerve. Masson, Paris, pp 45–48

    Google Scholar 

  18. Jannetta PJ (1987) Hemifacial spasm: Etiology and treatment. In: English G (ed) Otolaryngology, vol. 1, LL Lippincott, Philadelphia, pp 1–10

    Google Scholar 

  19. Jannetta PJ (1990) Cranial rhizopathies. In: Youmans JR (ed) Neurological surgery. W. B. Saunders, Philadelphia, pp 4169–4182

    Google Scholar 

  20. Jannetta PJ (1992) Microvascular decompression of the facial nerve for hemifacial spasm. In: Wilson CB (ed) Neurosurgical procedures: personal approaches to classic operations. Williams and Wilkins, Baltimore, pp 154–162

    Google Scholar 

  21. Jannetta PJ, Hackett E, Ruby JR (1970) Electromyographic and electronmicroscopic correlates in hemifacial spasm treated by microsurgical relief of neurovascular compression. Surg Forum 21: 449–451

    PubMed  CAS  Google Scholar 

  22. Jannetta PJ, Abbasy M, Maroon JC, Ramos FM, Albin MS (1977) Etiology and definite microsurgical treatment of hemifacial spasm: Operative technique and results in 47 patients. J Neurosurg 47: 321–328

    Article  PubMed  CAS  Google Scholar 

  23. Kim P, Fukushima T (1984) Observations on synkinesis in patients with hemifacial spasm. J Neurosurg 60: 821–827

    Article  PubMed  CAS  Google Scholar 

  24. Laine E, Nayrac C (1948) Hemispasme facial gueri par intervention sur la fosse posterieure. Rev Neurol 80: 38–40

    Google Scholar 

  25. Malis LI (1967) Petrous ridge compression and its surgical correction. J Neurosurg 26: 163–167

    Article  PubMed  Google Scholar 

  26. Moller AR (1988) Evoked potentials in intraoperative monitoring. Williams and Wilkins, Baltimore

    Google Scholar 

  27. Moller AR (1995) Intraoperative neurophysiologic monitoring. Gordon and Breach, Langhorne Pennsylvania (In press)

    Google Scholar 

  28. Moller AR, Jannetta PJ (1983) Monitoring auditory functions during cranial nerve microvascular decompression operations by direct recording from the eighth nerve. J Neurosurg 59: 493–499

    Article  PubMed  CAS  Google Scholar 

  29. Moller AR, Jannetta PJ (1984) On the origin of synkinesis in hemifacial spasm: Results of intracranial recordings. J Neurosurg 61: 569–576

    Article  PubMed  CAS  Google Scholar 

  30. Moller AR, Jannetta PJ (1985) Hemifacial spasm: Results of electrophysiologic recording during microvascular decompression operations. Neurology 35: 969–974

    PubMed  CAS  Google Scholar 

  31. Moller AR, Jannetta PJ (1985) Microvascular decompression in hemifacial spasm: Intraoperative electrophysiological observations. Neurosurgery 16: 612–618

    Article  PubMed  CAS  Google Scholar 

  32. Moller AR, Jannetta PJ (1985) Synkinesis in hemifacial spasm: Results of recording intracranially from the facial nerve. Experientia 41: 415–417

    Article  PubMed  CAS  Google Scholar 

  33. Moller AR, Jannetta PJ (1987) Monitoring facial EMG responses during microvascular decompression operations for hemifacial spasm. J Neurosurg 66: 681–685

    Article  PubMed  CAS  Google Scholar 

  34. Moller MB, Moller AR (1985) Audiometric abnormalities in hemifacial spasm. Audiology 24: 396–405

    Article  PubMed  CAS  Google Scholar 

  35. Moller AR, Moller MB (1989) Does intraoperative monitoring of auditory evoked potentials reduce incidence of hearing loss as a complication of microvascular decompression of cranial nerves? Neurosurgery 24: 257–263

    Article  PubMed  CAS  Google Scholar 

  36. Revilla AG (1947) Neurinomas of cerebellopontine recess. A clinical study of one hundred and sixty cases including operative mortality and end results. Johns Hopkins Hosp Bull 80: 254–296

    Google Scholar 

  37. Revilla AG (1948) Differential diagnosis of tumors at the cerebellopontine recess. Johns Hopkins Hosp Bull 33: 187–212

    Google Scholar 

  38. Schultze F (1875) Linksseitiger Facialiskrampf in Folge eines Aneurysma der Arteria vertebralis sinistra. Virchows Arch 65: 385–391

    Article  Google Scholar 

  39. Wilkins RH (1991) Hemifacial spasm: A review. Surg Neurol 36: 251–277

    Article  PubMed  CAS  Google Scholar 

  40. Wilkins RH (1993) Cranial nerve dysfunction syndromes: Evidence for microvascular compression. In: Barrow DL (ed), Neurosurgical Topics Book 13, Surgery of Cranial Nerves of the Posterior Fossa, Chapter 4. American Association of Neurological Surgeons, Park Ridge, Illinois, pp 155–163

    Google Scholar 

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© 1997 Springer-Verlag/Wien

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Rosseau, G.L., Jannetta, P.J. (1997). Surgical treatment of hemifacial spasm by microvascular decompression. In: Sindou, M., Keravel, Y., Møller, A.R. (eds) Hemifacial Spasm. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6829-5_10

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  • DOI: https://doi.org/10.1007/978-3-7091-6829-5_10

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7416-6

  • Online ISBN: 978-3-7091-6829-5

  • eBook Packages: Springer Book Archive

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