Biomaterial Database

Macrovascular Decompression for Hemifacial Spasm Using Sling Technique. 2023

Nickalus R Khan, and Eva M Wu, and Turki Elarjani, and Jacques J Morcos

Department of Neurological Surgery, University of Miami, Miami, Florida, USA.

Hemifacial spasm (HFS) is a painless, involuntary twitching of the facial muscles that usually involves the orbicularis oculi muscle.1,2 It is commonly caused by the anterior inferior cerebellar artery or posterior inferior cerebellar artery.1,2 However, a dolichoectatic vertebrobasilar artery (VBA) can impinge the facial nerve.1 Macrovascular decompression with sling transposition is a common management paradigm.1-9 We present a case of a 56-year-old male who presented with left-sided HFS, pulsatile tinnitus, and hearing loss for the past 2 years. The patient underwent a retrosigmoid craniotomy and Gore-Tex sling transposition of a dolichoectatic VBA (Video 1). Complete improvement of symptoms was noted postoperatively with no associated complications. We review the preoperative workup, operative technique, relevant anatomy, and literature and provide technical pearls for this procedure.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D003664	Decompression	Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent DECOMPRESSION SICKNESS. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings.
D005154	Facial Nerve	The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and SALIVARY GLANDS, and convey afferent information for TASTE from the anterior two-thirds of the TONGUE and for TOUCH from the EXTERNAL EAR.	Cranial Nerve VII,Marginal Mandibular Branch,Marginal Mandibular Nerve,Seventh Cranial Nerve,Nerve VII,Nerve of Wrisberg,Nervus Facialis,Nervus Intermedius,Nervus Intermedius of Wrisberg,Cranial Nerve VIIs,Cranial Nerve, Seventh,Facial Nerves,Mandibular Nerve, Marginal,Mandibular Nerves, Marginal,Marginal Mandibular Nerves,Nerve VIIs,Nerve, Facial,Nerve, Marginal Mandibular,Nerve, Seventh Cranial,Nerves, Marginal Mandibular,Nervus Faciali,Seventh Cranial Nerves,Wrisberg Nerve,Wrisberg Nervus Intermedius
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016896	Treatment Outcome	Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.	Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D061145	Microvascular Decompression Surgery	Surgery performed to relieve pressure from MICROVESSELS that are located around nerves and are causing NERVE COMPRESSION SYNDROMES.	Microvascular Decompression,Decompression Surgeries, Microvascular,Decompression Surgery, Microvascular,Decompression, Microvascular,Decompressions, Microvascular,Microvascular Decompression Surgeries,Microvascular Decompressions,Surgeries, Microvascular Decompression,Surgery, Microvascular Decompression
D019569	Hemifacial Spasm	Recurrent clonic contraction of facial muscles, restricted to one side. It may occur as a manifestation of compressive lesions involving the seventh cranial nerve (FACIAL NERVE DISEASES), during recovery from BELL PALSY, or in association with other disorders. (From Adams et al., Principles of Neurology, 6th ed, p1378)	Facial Spasm, Unilateral,Hemifacial Myokymia,Spasm, Hemifacial,Facial Spasms, Unilateral,Hemifacial Spasms,Myokymia, Hemifacial,Spasm, Unilateral Facial,Spasms, Hemifacial,Spasms, Unilateral Facial,Unilateral Facial Spasm,Unilateral Facial Spasms