Turkish Neurosurgery
MICROVASCULAR DECOMPRESSİON FOR HEMİFACİAL SPASM WİTHOUT THE USE OF NEUROMONİTORİNG AND FİX RETRACTİON:A SİNGLE-CENTER EXPERİENCE
SERHAT PUSAT1, EFDAL ERDOĞAN2, MURAT ATAR1, YAHYA CEM ERBAŞ 2, ERSİN ERDOĞAN2
1Sultan Abdulhamid Research and Training Hospital, Neurosurgery, İSTANBUL,
2Neurospine Academy Center, ANKARA ,
DOI: 10.5137/1019-5149.JTN.42249-22.3

Aim:Hemifacial spasm is a disorder that involves involuntary intermittent contractions caused by vascular compression of cranial nerve VII. It can be surgically treated by the application of microvascular decompression to the root entry zone of the nerve.Material and Methods:: Of the 78 patients with Hemifacial spasm operated by the senior author of this study between 2016 and 2020, 60 patients who were followed up were included and retrospectively investigated. The female to male ratio was 32:28, and the mean age was 42.5 ± 11.5 (23–71) years. All the patients were operated via the lateral retrosigmoid suboccipital infrafloccular approach. The operations were completed without the use of a permanent retractor. Additionally, intraoperative neuromonitoring was not performed in any of the patientsResults:Single vessel compression was observed in 77% of the patients, whereas 16% and 6% had compression in two and three vessels, respectively. Immediate recovery was achieved in 70% of the patients. Half of the remaining 30% fully recovered within 6 months–2 years. Furthermore, complaints of 5% of the patients were alleviated, whereas no change was observed in 10% of the patients. One of the patients developed recurrence. Conclusion:Microvascular decompression is a highly effective method for treating Hemifacial spasm. We did not resort to intraoperative neuromonitoring in our study and found our postoperative complication rates to be consistent with the literature.

Corresponding author : SERHAT PUSAT