Bridge technique for hemifacial spasm with vertebral artery involvement

Abstract

Background

To assess efficacy and safety of a newly developed decompression technique in microvascular decompression for hemifacial spasm (HFS) with vertebral artery (VA) involvement.

Methods

A rigid Teflon (Bard ^® PTFE Felt Pledget, USA) with the ends placed between the lower pons and the flocculus creates a free space over the root exit zone (REZ) of the facial nerve (bridge technique). The bridge technique and the conventional sling technique for VA-related neurovascular compression were compared retrospectively in 60 patients. Elapsed time for decompression, number of Teflon pieces used during the procedure, and incidences of intraoperative manipulation to the lower cranial nerves were investigated. Postoperative outcomes and complications were retrospectively compared in both techniques.

Results

The time from recognition of the REZ to completion of the decompression maneuvers was significantly shorter, and fewer Teflon pieces were required in the bridge technique than in the sling technique. Lower cranial nerve manipulations were performed less in the bridge technique. Although statistical analyses revealed no significant differences in surgical outcomes except spasm-free at postoperative 1 month, the bridge technique is confirmed to provide spasm-free outcomes in the long-term without notable complications.

Conclusions

The bridge technique is a safe and effective decompression method for VA-involved HFS.

Contributors

Takuro Inoue: [e-mail]

Journal

Journal ID (nlm-ta): Acta Neurochir (Wien)

Journal ID (iso-abbrev): Acta Neurochir (Wien)

Title: Acta Neurochirurgica

Publisher: Springer Vienna (Vienna )

ISSN (Print): 0001-6268

ISSN (Electronic): 0942-0940

Publication date (Electronic): 6 October 2021

Publication date PMC-release: 6 October 2021

Publication date (Print): 2021

Volume: 163

Issue: 12

Pages: 3311-3320

Affiliations

[1 ]Department of Neurosurgery, Subarukai Koto Memorial Hospital, 2-1 Hiramatsu-cho, Higashiohmi-shi, Shiga 527-0134 Japan

[2 ]Department of Neurosurgery, Indonesia National Brain Center Hospital, East Jakarta, Special Capital Region of Jakarta Indonesia

[3 ]Raleigh Neurosurgical Clinic, Raleigh, NC USA

[4 ]GRID grid.189509.c, ISNI 0000000100241216, Division of Neurosurgery, , Duke University Medical Center, ; Durham, NC USA

Article

Publisher ID: 5006

DOI: 10.1007/s00701-021-05006-8

PMC ID: 8599217

PubMed ID: 34613530

SO-VID: c8ff1d83-0200-4f5e-ad53-60236618ba2e

Copyright statement: © The Author(s) 2021

License:

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Categories

Subject: Original Article - Functional Neurosurgery - Other

Custom metadata

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