Download PDF
Skull Base 2001; 11(3): 189-198
DOI: 10.1055/s-2001-16607
CASE REPORTS

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Fully Endoscopic Vascular Decompression of the Facial Nerve for Hemifacial Spasm

Joseph B. Eby, Sung Tae Cha, Hrayr K. Shahinian
  • Division of Skull Base Surgery, Cedars-Sinai Medical Center, Los Angeles, California
Further Information

Publication History

Publication Date:
24 August 2001 (online)

    Permissions and Reprints

ABSTRACT

Hemifacial spasm is an uncommon disorder manifesting as a unilateral, involuntary, sporadic contraction of the musculature innervated by the seventh cranial nerve. Although debated, the etiology of hemifacial spasm is generally accepted as compression of the facial nerve by vessels of the posterior circulation. Early surgical techniques were ineffective and fraught with morbidity. Over the past 25 years microvascular decompression surgery has allowed the safe and effective treatment of hemifacial spasm. Recent reports combining microsurgical and endoscopic techniques have documented the advantages of the endoscope in exposing the anatomy of this region. Enhanced visualization allows a less traumatic dissection and increases the surgeon's ability to locate nerve-vessel conflicts often difficult to identify through the limited view of the microscope. This article reviews the history of hemifacial spasm and describes the first three cases of fully endoscopic vascular decompression for hemifacial spasm, emphasizing the advantages of this novel surgical approach.

KEYWORD

Endoscopy - hemifacial spasm - vascular decompression

REFERENCES

  • 1 Auger R G, Whisnant J P. Hemifacial spasm in Rochester and Olmsted County, Minnesota, 1960 to 1984.  Arch Neurol . 1990;  47 1233-1234
    CrossrefPubMedSearch in Google Scholar
  • 2 Fukushima T. Microvascular decompression for hemifacial spasm: Result in 2890 cases. In: Spetzler RF ed. Neurovascular Surgery New York: McGraw Hill Inc 1995: 1133-1145
    Search in Google Scholar
  • 3 Hansen C, Montgomery J EB. Hemifacial spasm: Medical treatment. In: Spetzler RF ed. Neurovascular Surgery New York: McGraw Hill Inc 1995: 1119-1131
    Search in Google Scholar
  • 4 Wilkins R H. Hemifacial spasm: a review.  Surg Neurol . 1991;  36 251-277
    CrossrefPubMedSearch in Google Scholar
  • 5 Digre K, Corbett J J. Hemifacial spasm: differential diagnosis, mechanism, and treatment.  Adv Neurol . 1988;  49 151-176
    PubMedSearch in Google Scholar
  • 6 Ehni G, Woltman H W. Hemifacial spasm. Review of 106 cases.  Arch Neurol Psychiatry . 1945;  53 205
    PubMedSearch in Google Scholar
  • 7 Coleman C C. Surgical treatment of facial spasm.  Ann Surg . 1937;  105 647-657
    PubMedSearch in Google Scholar
  • 8 Gardner J W. Hemifacial Spasm-A reversible pathophysiologic state.  J Neurosurg . 1962;  27 240-247
    PubMedSearch in Google Scholar
  • 9 Sutherland S. Neurovascular relations and anomalies at the base of the brain.  J Neurol Neurosurg Psychiatry . 1948;  11 243-258
    PubMedSearch in Google Scholar
  • 10 Sunderland S. The arterial relations of the internal auditory meatus.  Brain . 1945;  68 23-27
    PubMedSearch in Google Scholar
  • 11 Dandy W. Concerning the cause of trigeminal neuralgia.  Am J Surg . 1934;  24 447-455
    CrossrefPubMedSearch in Google Scholar
  • 12 Revilla A G, Dandy W. Neurinomas of the cerebellopontile recess.  Johns Hopkins Hosp Bull . 1947;  80 254-296
    PubMedSearch in Google Scholar
  • 13 Campbell E, Keedy C. Hemifacial spasm: a note on the etiology in two cases.  J Neurosurg . 1947;  4 342-347
    PubMedSearch in Google Scholar
  • 14 Gardner J W. Five-year cure of hemifacial spasm.  Cleve Clin Q . 1960;  27 219-221
    PubMedSearch in Google Scholar
  • 15 Magnan J, Caces F, Locatelli P, Chays A. Hemifacial spasm: endoscopic vascular decompression.  Otolaryngol Head Neck Surg . 1997;  117 308-314
    PubMedSearch in Google Scholar
  • 16 Jannetta P J. Trigeminal neuralgia and hemifacial spasm-etiology and definitive treatment.  Trans Am Neurol Assoc . 1975;  100 89-91
    PubMedSearch in Google Scholar
  • 17 Jannetta P J, Abbasy M, Maroon J C, Ramos F M, Albin M S. Etiology and definitive microsurgical treatment of hemifacial spasm. Operative techniques and results in 47 patients.  J Neurosurg . 1977;  47 321-328
    CrossrefPubMedSearch in Google Scholar
  • 18 Ruby J R, Jannetta P J. Hemifacial spasm: ultrastructural changes in the facial nerve induced by neurovascular compression.  Surg Neurol . 1975;  4 369-370
    PubMedSearch in Google Scholar
  • 19 Gardner J W. Concerning the mechanism of trigeminal neuralgia and hemifacial spasm.  J Neurosurg . 1962;  19 947-958
    CrossrefPubMedSearch in Google Scholar
  • 20 Gardner J W. Cross talk-the paradoxical transmission of a nerve impulse.  Arch Neurol . 1966;  14 149-156
    PubMedSearch in Google Scholar
  • 21 Nielsen V K. Electrophysiology of the facial nerve in hemifacial spasm: ectopic/ephaptic excitation.  Muscle Nerve . 1985;  8 545-555
    CrossrefPubMedSearch in Google Scholar
  • 22 Nielsen V K, Jannetta P J. Pathophysiology of hemifacial spasm: III. Effects of facial nerve decompression.  Neurology . 1984;  34 891-897
    PubMedSearch in Google Scholar
  • 23 Moller A R. Hemifacial spasm: ephaptic transmission or hyperexcitability of the facial motor nucleus?.  Exp Neurol . 1987;  98 110-119
    CrossrefPubMedSearch in Google Scholar
  • 24 Auger R G, Piepgras D G, Laws Jr R E, Miller R H. Microvascular decompression of the facial nerve for hemifacial spasm: clinical and electrophysiologic observations.  Neurology . 1981;  31 346-350
    CrossrefPubMedSearch in Google Scholar
  • 25 Wilkins R H. Hemifacial spasm: treatment by microvascular decompression of the facial nerve at the pons.  South Med J . 1981;  74 1471-1474
    PubMedSearch in Google Scholar
  • 26 Iwakuma T, Matsumoto A, Nakamura N. Hemifacial spasm. Comparison of three different operative procedures in 110 patients.  J Neurosurg . 1982;  57 753-756
    PubMedSearch in Google Scholar
  • 27 Loeser J D, Chen J. Hemifacial spasm: treatment by microsurgical facial nerve decompression.  Neurosurgery . 1983;  13 141-146
    PubMedSearch in Google Scholar
  • 28 Eidelman B H, Nielsen V K, Moller M, Jannetta P J. Vascular compression, hemifacial spasm, and multiple cranial neuropathy.  Neurology . 1985;  35 712-716
    PubMedSearch in Google Scholar
  • 29 Wilkins R H. Neurovascular compression syndromes.  Neurol Clin . 1985;  3 359-372
    PubMedSearch in Google Scholar
  • 30 Auger R G, Piepgras D G, Laws Jr R E. Hemifacial spasm: results of microvascular decompression of the facial nerve in 54 patients.  Mayo Clin Proc . 1986;  61 640-644
    PubMedSearch in Google Scholar
  • 31 Niemeyer Filho P, Bezerra M, Mufarrej G. Hemifacial spasm: results of microvascular decompression in 53 patients.  Arq Neuropsiquiatr . 1990;  48 210-216
    PubMedSearch in Google Scholar
  • 32 Huang C I, Chen I H, Lee L S. Microvascular decompression for hemifacial spasm: analyses of operative findings and results in 310 patients.  Neurosurgery . 1992;  30 53-56
    PubMedSearch in Google Scholar
  • 33 Magnan J, Chays A, Caces F. Role of endoscopy and vascular decompression in the treatment of hemifacial spasm.  Ann Otolaryngol Chir Cervicofac . 1994;  111 153-160
    PubMedSearch in Google Scholar
  • 34 Magnan J, Chays A, Lepetre C, Pencroffi E, Locatelli P. Surgical perspectives of endoscopy of the cerebellopontine angle.  Am J Otol . 1994;  15 366-370
    PubMedSearch in Google Scholar
  • 35 Barker II G F, Jannetta P J, Bissonette D J, Shields P T, Larkins M V, Jho H D. Microvascular decompression for hemifacial spasm.  J Neurosurg . 1995;  82 201-210
    PubMedSearch in Google Scholar
  • 36 Zhang K W, Shun Z T. Microvascular decompression by the retrosigmoid approach for idiopathic hemifacial spasm: experience with 300 cases.  Ann Otol Rhinol Laryngol . 1995;  104 610-612
    PubMedSearch in Google Scholar
  • 37 Caces F, Chays A, Locatelli P. Neuro-vascular decompression in hemifacial spasm: anatomical, electrophysiological and therapeutic results apropos of 100 cases.  Rev Laryngol Otol Rhinol . 1996;  117 347-351
    PubMedSearch in Google Scholar
  • 38 Illingworth R D, Porter D G, Jakubowski J. Hemifacial spasm: a prospective long term follow up of 83 cases treated by microvascular decompression at two neurosurgical centers in the United Kingdom.  Neurol Neurosurg Psychiatry . 1996;  60 72-77
    PubMedSearch in Google Scholar
  • 39 Kondo A. Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm.  Neurosurgery . 1997;  40 46-51
    PubMedSearch in Google Scholar
  • 40 Moller A R. Vascular compression of cranial nerves. I. History of the microvascular decompression operation.  Neurol Res . 1998;  20 727-731
    PubMedSearch in Google Scholar
  • 41 McLaughlin M R, Jannetta P J, Clyde B L, Subach B R, Comey C H, Resnick D K. Microvascular decompression of cranial nerves: lessons learned after 4400 operations.  J Neurosurg . 1999;  90 1-8
    CrossrefPubMedSearch in Google Scholar
  • 42 Kureshi SA,Wilkins R H. Posterior fossa reexploration for persistent or recurrent trigeminal neuralgia or hemifacial spasm: surgical findings and therapeutic implications.  Neurosurgery . 1998;  43 1111-1117
    CrossrefPubMedSearch in Google Scholar
  • 43 Haines S J, Torres F. Intraoperative monitoring of the facial nerve during decompressive surgery for hemifacial spasm.  J Neurosurg . 1991;  74 254-257
    CrossrefPubMedSearch in Google Scholar
  • 44 Hanakita J, Kondo A. Serious complications of microvascular decompression operations for trigeminal neuralgia and hemifacial spasm.  Neurosurgery . 1988;  22 348-352
    PubMedSearch in Google Scholar
  • 45 Nishihara K, Hanakita J, Kinuta Y, Kondo A, Yamamoto Y, Nakatani H. Importance of intraoperative monitoring of ABR and compound action potential of the eighth cranial nerve during microvascular decompression surgery.  No Shinkei Geka . 1986;  14 509-518
    PubMedSearch in Google Scholar
  • 46 Radtke R A, Erwin C W, Wilkins R H. Intraoperative brainstem auditory evoked potentials: significant decrease in postoperative morbidity.  Neurology . 1989;  39 187-191
    CrossrefPubMedSearch in Google Scholar
  • 47 Moller A R, Moller M B. Does intraoperative monitoring of auditory evoked potentials reduce incidence of hearing loss as a complication of microvascular decompression of cranial nerves?.  Neurosurgery . 1989;  24 257-263
    PubMedSearch in Google Scholar
  • 48 O'Donoghue G M, O'Flynn P. Endoscopic anatomy of the cerebellopontine angle.  Am J Otol . 1993;  14 122-125
    CrossrefPubMedSearch in Google Scholar
  • 49 Jennings C R, O'Donoghue G M. Posterior fossa endoscopy.  J Laryngol Otol . 1998;  112 227-229
    PubMedSearch in Google Scholar
  • 50 Bremond G, Garcin M, Magnan J, Bonnaud G. L'abord à minima de l'espace pon to-cerebelleux.  Cah ORL . 1974;  9 443-460
    PubMedSearch in Google Scholar
  • 51 Doyen E. Surgical therapeutics and operative techniques. In: Balliere, Tindall, Cox, eds. vol 1 London, Inc; 1917: 599-602
    Search in Google Scholar