What is the role of surgery in the treatment of hemifacial spasm?

Updated: Sep 16, 2019
  • Author: Steven Gulevich, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Treat compressive lesions surgically. Ectatic blood vessels cause hemifacial spasm by compressing the facial nerve as it exits the brainstem. Surgical decompression of these blood vessels can yield excellent results. [11, 12, 13, 14] A study evaluating the effect of microvascular decompression surgery on idiopathic hemifacial spasm with compression on different zones of facial nerve found that proper detection of offending vessels and complete decompression may increase cure rate. [15]

Patients with apparently idiopathic hemifacial spasm may benefit from posterior fossa exploration and microvascular decompression. Myectomy rarely is required.

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