Fully Endoscopic Vascular Decompression of the Facial Nerve for Hemifacial Spasm

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
• 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
• 3 Hansen C, Montgomery J EB. Hemifacial spasm: Medical treatment. In: Spetzler RF ed. Neurovascular Surgery New York: McGraw Hill Inc 1995: 1119-1131
• 4 Wilkins R H. Hemifacial spasm: a review.  Surg Neurol . 1991;  36 251-277
• 5 Digre K, Corbett J J. Hemifacial spasm: differential diagnosis, mechanism, and treatment.  Adv Neurol . 1988;  49 151-176
• 6 Ehni G, Woltman H W. Hemifacial spasm. Review of 106 cases.  Arch Neurol Psychiatry . 1945;  53 205
• 7 Coleman C C. Surgical treatment of facial spasm.  Ann Surg . 1937;  105 647-657
• 8 Gardner J W. Hemifacial Spasm-A reversible pathophysiologic state.  J Neurosurg . 1962;  27 240-247
• 9 Sutherland S. Neurovascular relations and anomalies at the base of the brain.  J Neurol Neurosurg Psychiatry . 1948;  11 243-258
• 10 Sunderland S. The arterial relations of the internal auditory meatus.  Brain . 1945;  68 23-27
• 11 Dandy W. Concerning the cause of trigeminal neuralgia.  Am J Surg . 1934;  24 447-455
• 12 Revilla A G, Dandy W. Neurinomas of the cerebellopontile recess.  Johns Hopkins Hosp Bull . 1947;  80 254-296
• 13 Campbell E, Keedy C. Hemifacial spasm: a note on the etiology in two cases.  J Neurosurg . 1947;  4 342-347
• 14 Gardner J W. Five-year cure of hemifacial spasm.  Cleve Clin Q . 1960;  27 219-221
• 15 Magnan J, Caces F, Locatelli P, Chays A. Hemifacial spasm: endoscopic vascular decompression.  Otolaryngol Head Neck Surg . 1997;  117 308-314
• 16 Jannetta P J. Trigeminal neuralgia and hemifacial spasm-etiology and definitive treatment.  Trans Am Neurol Assoc . 1975;  100 89-91
• 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
• 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
• 19 Gardner J W. Concerning the mechanism of trigeminal neuralgia and hemifacial spasm.  J Neurosurg . 1962;  19 947-958
• 20 Gardner J W. Cross talk-the paradoxical transmission of a nerve impulse.  Arch Neurol . 1966;  14 149-156
• 21 Nielsen V K. Electrophysiology of the facial nerve in hemifacial spasm: ectopic/ephaptic excitation.  Muscle Nerve . 1985;  8 545-555
• 22 Nielsen V K, Jannetta P J. Pathophysiology of hemifacial spasm: III. Effects of facial nerve decompression.  Neurology . 1984;  34 891-897
• 23 Moller A R. Hemifacial spasm: ephaptic transmission or hyperexcitability of the facial motor nucleus?.  Exp Neurol . 1987;  98 110-119
• 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
• 25 Wilkins R H. Hemifacial spasm: treatment by microvascular decompression of the facial nerve at the pons.  South Med J . 1981;  74 1471-1474
• 26 Iwakuma T, Matsumoto A, Nakamura N. Hemifacial spasm. Comparison of three different operative procedures in 110 patients.  J Neurosurg . 1982;  57 753-756
• 27 Loeser J D, Chen J. Hemifacial spasm: treatment by microsurgical facial nerve decompression.  Neurosurgery . 1983;  13 141-146
• 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
• 29 Wilkins R H. Neurovascular compression syndromes.  Neurol Clin . 1985;  3 359-372
• 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
• 31 Niemeyer Filho P, Bezerra M, Mufarrej G. Hemifacial spasm: results of microvascular decompression in 53 patients.  Arq Neuropsiquiatr . 1990;  48 210-216
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 39 Kondo A. Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm.  Neurosurgery . 1997;  40 46-51
• 40 Moller A R. Vascular compression of cranial nerves. I. History of the microvascular decompression operation.  Neurol Res . 1998;  20 727-731
• 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
• 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
• 43 Haines S J, Torres F. Intraoperative monitoring of the facial nerve during decompressive surgery for hemifacial spasm.  J Neurosurg . 1991;  74 254-257
• 44 Hanakita J, Kondo A. Serious complications of microvascular decompression operations for trigeminal neuralgia and hemifacial spasm.  Neurosurgery . 1988;  22 348-352
• 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
• 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
• 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
• 48 O'Donoghue G M, O'Flynn P. Endoscopic anatomy of the cerebellopontine angle.  Am J Otol . 1993;  14 122-125
• 49 Jennings C R, O'Donoghue G M. Posterior fossa endoscopy.  J Laryngol Otol . 1998;  112 227-229
• 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
• 51 Doyen E. Surgical therapeutics and operative techniques. In: Balliere, Tindall, Cox, eds. vol 1 London, Inc; 1917: 599-602