CC BY-NC-ND 4.0 · J Neurol Surg B 2019; 80(S 03): S318-S319
DOI: 10.1055/s-0038-1675166
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Lateral Basal Approach to CPA in Supine No-Retractor Method: Microvascular Decompression for Hemifacial Spasm

Katsuyoshi Shimizu
1  Department of Neurosurgery, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
› Author Affiliations
Further Information

Address for correspondence

Katsuyoshi Shimizu, MD
Department of Neurosurgery
Showa University School of Medicine, 5-8 Hatanodai 1, Shinagawa-ku Tokyo 142-8666
Japan   

Publication History

30 May 2018

19 August 2018

Publication Date:
23 October 2018 (eFirst)

 

    Abstract

    Objectives In this video, we demonstrate our more basal approach in microvascular decompression for hemifacial spasm.

    Design The patient is in supine position with the head rotated maximally to the opposite side on the U-shaped head rest. The small cranial window is made at the lateral bottom of occipital cranium with the adequate superficial manipulation on the muscles layers in the craniocervical junction.

    Results The more basal approach enables the surgeon to access all the segments of the VIIth nerve tract without cerebellar retraction by spatula, especially in the case with vertebral artery associated compression.

    Conclusion This approach safely provides the ideal operative corridor promising sufficient decompression in micorvascular decompression for the VIIth nerve.

    The link to the video can be found at: https://youtu.be/_nKSjGEHoB4.


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    Zoom Image
    Fig. 1 Pre- and postoperative MRIs indicate decompression has been successfully done. MRI, magnetic resonance imaging.
    Zoom Image
    Fig. 2 (a) The superficial view after muscle preparation. The bottom of the occipital cranium has been disclosed. (b) The unique surgical corridor of this approach exposing the entire facial nerve tract. OA, occipital artery.

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    Quality:

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    Conflict of Interest

    None.

    Address for correspondence

    Katsuyoshi Shimizu, MD
    Department of Neurosurgery
    Showa University School of Medicine, 5-8 Hatanodai 1, Shinagawa-ku Tokyo 142-8666
    Japan   

      
    Zoom Image
    Fig. 1 Pre- and postoperative MRIs indicate decompression has been successfully done. MRI, magnetic resonance imaging.
    Zoom Image
    Fig. 2 (a) The superficial view after muscle preparation. The bottom of the occipital cranium has been disclosed. (b) The unique surgical corridor of this approach exposing the entire facial nerve tract. OA, occipital artery.