Key-hole dual-mirror combined microvascular decompression for the treatment of hemifacial spasm

Microvascular decompression is the main operative method to treat hemifascial spasm. In this study we aimed to explore the effect and safety of key-hole dual-mirror combined microvascular decompression for the treatment of hemifacial spasm. There were 18 males and 52 females in this group. Their age ranged from 27 to 79 years, and their illness duration from 1 to 10 years. Among them there were 38 cases with hemifacial spasm in the left side, 32 cases in the right side. All the patients underwent MRI 3D-TOF examination. After confirming the possibility of vessel compressing the nerve root, key-hole dual-mirror combined microvascular decompression was performed under general anesthesia.Symptom improvement was followed up for 3–120 months postoperatively. After the operation the effective rate of hemifacial spasm was 91.43%(64/70). Hearing loss appeared in 3 cases, delayed facial paralysis in 2 cases, transient dizziness and tinnitus in 2 cases, CSF otorrhea in 2 cases and SAH in 1 case. After active treatments all the symptoms improved. The follow-up showed 2 cases(2.86%) recurred. This study shows that microvascular decompression is the most effective way for the treatment of hemifacial spasm. In order to improve the surgical effect and to reduce symptom recurrence, the key points are skilled microsurgical technique、correct identification of the responsible vessel under the combination of microscope and endoscope 、adequate decompression during the operation.