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CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2019; 80(S 03): S312-S313
DOI: 10.1055/s-0039-1688807
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Endoscopic-Assisted Microvascular Decompression of Ectatic Vertebral Artery for Hemifacial Spasm: Operative Video and Technical Nuances

James K. Liu
1   Department of Neurological Surgery, Center for Cerebrovascular and Skull Base Surgery, Rutgers University, New Jersey Medical School, Neurological Institute of New Jersey, RWJ Barnabas Health, Livingston and Newark, New Jersey, United States
,
Vincent N. Dodson
1   Department of Neurological Surgery, Center for Cerebrovascular and Skull Base Surgery, Rutgers University, New Jersey Medical School, Neurological Institute of New Jersey, RWJ Barnabas Health, Livingston and Newark, New Jersey, United States
› Author Affiliations
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Publication History

30 March 2019

02 April 2019

Publication Date:
30 April 2019 (online)

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Abstract

In this operative video atlas manuscript, the authors demonstrate the operative nuances and surgical technique for endoscopic-assisted microvascular decompression of a large ectatic vertebral artery causing hemifacial spasm. A retrosigmoid approach was performed and a large ectatic vertebral artery was transposed away from the root exit zone of cranial nerve VII ([Fig. 1]). The lateral spread response disappeared, signifying adequate decompression of the facial nerve ([Fig. 2]). The use of endoscopic-assistance during the microsurgical decompression was very useful to confirm the origin and also the resolution of neurovascular conflict. Postoperatively, the patient experienced immediate resolution of hemifacial spasm with normal facial nerve and hearing function. Written consent was obtained from the patient to publish videos, photographs, and images from the surgery.

The link to the video can be found at: https://youtu.be/RlMz44uCDCw.

Keywords

microvascular decompression - endoscopic assistance - hemifacial spasm - ectatic vertebral artery