Management of vessels passing through the facial nerve in the treatment of hemifacial spasm

Acta neurochirurgica
Baohui FengShiting Li

Abstract

In hemifacial spasm, it is extremely rare to find a vessel passing through the facial nerve. In this study, we present our experience of the surgical treatment of four such patients. From January 2010 to Match 2015, we treated 2,576 hemifacial spasm patients with microvascular decompression in our department. Of these, four had an intraneural vessel. Intraoperative findings and treatment were recorded, and postoperative outcomes were analyzed. In three patients, the intraneural vessel was the anterior inferior cerebellar artery, which we wrapped with small pieces of wet gelatin and Teflon sponge. A small vein found in the fourth patient was treated with facial nerve combing. Complete decompression was achieved and abnormal muscle response disappeared. Three patients got an excellent result and one patient got a good result. One patient had postoperative facial paralysis, which improved over 10 months of follow-up. If an artery passes through the facial nerve, it can be decompressed by wrapping the vessel with wet gelatin and Teflon sponge. If a vein passes through the facial nerve, combing can be used. Intraoperative abnormal muscle response monitoring is very helpful in achieving complete decompression.

References

Apr 1, 1985·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·J W House, D E Brackmann
Sep 2, 2008·Journal of Neurosurgery·Mauricio Campos-Benitez, Anthony M Kaufmann
Nov 15, 2011·Neurological Research·Xuesheng ZhengShiting Li
Dec 16, 2011·British Journal of Neurosurgery·Larry E Miller, Valerie M Miller
Feb 9, 2012·Clinical Neurology and Neurosurgery·Jun ZhongXu-Ming Hua
Jan 23, 2013·Neurological Research·Xinyuan LiShiting Li
Mar 27, 2015·Journal of Korean Neurosurgical Society·Chang Hyun OhEun-Young Kim

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Citations

Oct 19, 2014·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·Aleksandar KibelInes Drenjancevic
Mar 7, 2020·Acta neurochirurgica·Bao-Hui FengXu-Hui Wang
May 20, 2021·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Bowen ChangShiting Li

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