Recurrent Factors and Reoperation Strategies in Microvascular Decompression for Hemifacial Spasm

In cases of recurrent hemifacial spasm after MVD, improper placement of the Teflon pledget, leading to compression of the facial nerve exit zone by the vessel or pledget, is the main cause. Reoperation with MVD remains safe and effective for recurrent cases. The key to successful surgery includes the surgeon's proficient microsurgical techniques, rich surgical experience, cautious and patient intraoperative manipulation, and meticulous perioperative management.