Endoscope-Assisted Microvascular Decompression for the Management of Hemifacial Spasm Caused by Vertebrobasilar Dolichoectasia

Refaee, Ehab El; Langner, Soenke; Marx, Sascha; Rosenstengel, Christian; Baldauf, Jörg; Schroeder, Henry W. S.

doi:10.1016/j.wneu.2018.09.166

Cited by 21 publications

(14 citation statements)

References 36 publications

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“…Endoscopic-assisted craniotomy has been reported in many cases, such as clipping,[ 7 , 8 , 15 ] additional resection of skull base tumors,[ 1 , 2 , 20 ] and compression of blood vessels in MVD. [ 3 , 5 , 10 ] Although it has been reported to be useful in confirmation,[ 11 , 12 ] inserting an endoscope under a microscope poses a risk of tissue damage in the superficial surgical field. Because it is difficult to observe the entire surgical field with a normal microscope, it is necessary to insert the endoscope with the scope the microscope far away from the surgical field when inserting the endoscope.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the introduction of an endoscope for cases with blind spots during surgery was safe and useful. There is only report of combined use of an endoscope in exoscopic surgery,[ 5 ] though no case with ORBEYE use has been reported. In this study, we retrospectively examined the results of endoscopic-assisted surgery using the exoscope ORBEYE that we performed at our hospital.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of endoscope-assisted surgery under exoscopic view in skull base surgery: A technical note

Yano¹,

Hiraoka²,

Morita³

et al. 2022

Surgical Neurology International

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Background: The use of the exoscope has been increasing in the field of neurosurgery, as it can set the visual axis freely, enabling the surgeon to operate in a comfortable posture. Although endoscope-assisted surgery for compensation of insufficient surgical field is useful under the microscope, we report that using an endoscope in exoscopic surgery is safer and more useful. Methods: The exoscope used was ORBEYE. All surgical procedures were performed exoscopically from the beginning of the surgery. When endoscopic observation was required during the operation, the endoscope was inserted under observation by an exoscope. The exoscopic screen was 4K-3D and endoscopic screen was 4K-2D, the operation was performed while observing both screens at the same time. The endoscope was held manually or by a mechanical holder. Results: Twenty-two cases, including 14 requiring microvascular decompression (MVD) and eight requiring tumor removal, were performed by endoscopic-assisted exoscopic surgery. The endoscope could be inserted safely because its relationship with the surrounding structure could be observed under the exoscope, and the operator could observe both screens without moving the head. Fourteen of 22 patients required additional endoscopic treatment. Satisfactory two-handed operation was performed in 13 cases. Symptomatology disappeared in all cases of MVD, and sufficient tumor resection was achieved. Conclusion: Exoscopic surgery provides excellent surgical view that is not inferior to conventional microsurgery. As a large space can be secured between the scope and the surgical field, it is safer and easier to manipulate the endoscope under the exoscope.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of endoscope-assisted surgery under exoscopic view in skull base surgery: A technical note

Yano¹,

Hiraoka²,

Morita³

et al. 2022

Surgical Neurology International

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“…This is more essential in case of less potential space created by a huge offending artery, vertebrobasilar dolichoectasia. The efficacy and safety of endoscopic-assisted microvascular decompression had been shown in the management of hemifacial spasm [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: A case report

Duong

Pham

et al. 2021

International Journal of Surgery Case Reports

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“…The course of the facial nerve was inspected. Depending on the anatomical situation, the decompression was done by interposing shredded Teflon or transposing the vessel using a Gortex or Teflon sling and fixing it to the skull base dura [ 13 ]. Every attempt was made to leave the original compression zone free of contact to Teflon [ 9 , 11 ].…”

Section: Methodsmentioning

confidence: 99%

A multivariable prediction model for recovery patterns and time course of symptoms improvement in hemifacial spasm following microvascular decompression

et al. 2022

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Background Microvascular decompression (MVD) success rates exceed 90% in hemifacial spasm (HFS). However, postoperative recovery patterns and durations are variable. Objective We aim to study factors that might influence the postoperative patterns and duration needed until final recovery. Method Only patients following de-novo MVD with a minimum follow-up of 6 months were included. Overall trend of recovery was modeled. Patients were grouped according to recognizable clinical recovery patterns. Uni- and multivariable analyses were used to identify the factors affecting allocation to the identified patterns and time needed to final recovery. Results A total of 323 (92.6%) patients had > 90% symptom improvement, and 269 (77.1%) patients had complete resolution at the last follow-up. The overall trend of recovery showed steep remission within the first 6 months, followed by relapse peaking around 8 months with a second remission ~ 16 months. Five main recovery patterns were identified. Pattern analysis showed that evident proximal indentation of the facial nerve at root exit zone (REZ), males and facial palsy are associated with earlier recovery at multivariable and univariable levels. anterior inferior cerebellar artery (AICA), AICA/vertebral artery compressions and shorter disease durations are related to immediate resolution of the symptoms only on the univariable level. Time analysis showed that proximal indentation (vs. distal indentation), males and facial palsy witnessed significantly earlier recoveries. Conclusion Our main finding is that in contrast to peripheral indentation, proximal indentation of the facial nerve at REZ is associated with earlier recovery. Postoperative facial palsy and AICA compressions are associated with earlier recoveries. We recommend a minimum of 1 year before evaluating the final outcome of MVD for HFS.

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Endoscope-Assisted Microvascular Decompression for the Management of Hemifacial Spasm Caused by Vertebrobasilar Dolichoectasia

Cited by 21 publications

References 36 publications

Usefulness of endoscope-assisted surgery under exoscopic view in skull base surgery: A technical note

Usefulness of endoscope-assisted surgery under exoscopic view in skull base surgery: A technical note

Endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: A case report

A multivariable prediction model for recovery patterns and time course of symptoms improvement in hemifacial spasm following microvascular decompression

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