Endoscopically Assisted Minimally Invasive Microvascular Decompression of Hemifacial Spasm

Badr-El-Dine, Mohamed; Hf, El-Garem; Am, Talaat; Magnan, J.

doi:10.1097/00129492-200203000-00002

Cited by 68 publications

(30 citation statements)

References 15 publications

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“…The endoscopically assisted retrosigmoid approach was initially developed by Bremond and Magnan [39][40][41][42][43][44][45][46][47][48][49] . Using endoscope-assisted surgery in vascular compression syndrome, the CPA is explored by a 30°-angled endoscope, which gives a panoramic view of this space and allows clear visualization of the whole trigeminal nerve region; this allows precise mapping of the site and the course of the offending vessel, minimizing missing any offending vessel and extensive retraction and dissection in the CPA.…”

Section: Discussionmentioning

confidence: 99%

Endoscopy-Assisted Microvascular Decompression for Trigeminal Neuralgia: The Prognostic Impact of Interposing Material

Haidar¹,

Montava²,

Collin³

et al. 2014

Int Adv Otol

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OBJECTIVE:Trigeminal neuralgia is a disorder associated with severe episodes of lancinating pain in the distribution of trigeminal nerve. The majority of these patients eventually requires surgical management to achieve remission of symptoms. Microvascular decompression addresses the root cause of the disease and is more effective than ablative procedures at preventing recurrence of symptoms. However, several long-term follow-up studies have disclosed that the efficacy of the procedure gradually decreases over time and have related recurrence to some clinical variables. Our objective is to study the impact of the type of interposing materials used for decompression on long-term success rate. MATERIALS and METHODS:We conducted a retrospective chart review of 65 patients with trigeminal neuralgia operated between 2007 and 2010 in an otology/base of skull tertiary referral center. Endoscopy-assisted microvascular decompression was used for all patients. Three types of interposing material were used: Teflon in 30 patients (Group I); muscle in 19 patients (Group II); and a combination of both in 16 patients (Group III). The minimum follow-up period was 3 years. RESULTS:In total, 17 (26.1%) of the 65 patients had recurrence of their symptoms. Average time for recurrence was 7.82+/-4.31 months; 95% of recurrences appeared within the first year. Recurrence rate was lower in Group II (5.2%) as compared to Group I (40%) and Group III (23%), and the difference was statistically significant (p≤0.05). CONCLUSION:Microvascular decompression with interposition of a muscle pad carries a lower recurrence rate as compared to interposition of Teflon alone or in combination with muscle.

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Section: Discussionmentioning

confidence: 99%

Endoscopy-Assisted Microvascular Decompression for Trigeminal Neuralgia: The Prognostic Impact of Interposing Material

Haidar¹,

Montava²,

Collin³

et al. 2014

Int Adv Otol

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“…Bader-el-Dine and El-Garem [21][22][23], and Rosenberg and colleagues [24] reviewed the role of the endoscope in neurotologic procedures. McKennan described the secondlook endoscopic inspection of mastoid cavities that was achieved through a small postauricular incision [6].…”

Section: Historymentioning

confidence: 99%

Endoscopic transcanal middle ear surgery

Tarabichi

2010

Indian J Otolaryngol Head Neck Surg

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The advantages and limitations of the microscope of choice for the treatment of diseases of the middle ear. The wide-angle view provided by the endoscope enables transcanal access to the tympanic cavity, and its otherwise recess, and hypotympanum. These areas are the primary sites of disease and surgical failure to cure. The endoscope also allows an all encompassing view of the three main elements in tympanoplasty surgery: The ear canal, tympanic membrane, and the tympanic ring. This report is a summary transcanal operative endoscopy as the primary approach to the management of middle ear disease.

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“…Therefore, it has been generally accepted that MVD of the compressing vessels from the REZ is an effective treatment option for HFS 3,[12][13][14][15][16][17]19,22,23,26,29,33,39) . The REZ has been regarded as the area in which the sheath of the facial nerve is converted to the peripheral myelin composed of Schwann cells from the central glial myelin 6,13,35) .…”

Section: Compression Sitesmentioning

confidence: 99%

“…The lateral suboccipital retrosigmoid approach is commonly used to treat lesions in the cerebellopontine angle. This approach has been modified according to the specific surgical anatomy required for certain operations including cerebrovascular, tumor surgery and also MVD 3,5,19,21,25,32,38) . Advancement of surgical instruments, operating microscope and endoscope has made minimally invasive modifications of this approach.…”

Section: Infra-nuchal Infra-floccular Approachmentioning

confidence: 99%

Infranuchal Infrafloccular Approach to the More Vulnerable Segments of the Facial Nerve in Microvascular Decompressions for the Hemifacial Spasm

Park

Chang

Han

2009

J Korean Neurosurg Soc

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Objective : We investigated the locations of compressing vessels in hemifacial spasm. To approach compression sites, we described and evaluated the efficacy of the infranuchal infrafloccular (INIF) approach. Methods : A retrospective review of 31 consecutive patients who underwent microvascular decompression (MVD) through INIF with a minimum follow-up of 1 year was performed. Along the intracranial facial nerve, we classified the compression sites into the transitional zone (TRZ), the central nervous system (CNS) segment and the peripheral nervous system (PNS) segment. The INIF approach was used to inspect the CNS segment and the TRZ. Subdural patch graft technique was used in order to achieve watertight dural closure. The cranioplasty was performed using polymethylmethacrylate. The outcome and procedure-related morbidities were evaluated. Results : Twenty-nine patients (93%) showed complete disappearance of spasm. In two patients, the spasm was resolved gradually in 2 and 4 weeks, respectively. Late recurrence was noted in one patient (3%). The TRZ has been identified as the only compression site in 19 cases (61.3%), both the TRZ and CNS segment in 11 (35.5%) and the CNS segment only in 1 (3.2%). There was no patient having a compressing vessel in the PNS segment. Infection as a result of cerebrospinal fluid leak occurred in one patient (3%). Delayed transient facial weakness occurred in one patient. Conclusion : The TRZ and the CNS segment were more vulnerable area to the compression of vessels. We suggest that surgical avenue with the INIF approach provides early identification of this area.

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Endoscopically Assisted Minimally Invasive Microvascular Decompression of Hemifacial Spasm

Cited by 68 publications

References 15 publications

Endoscopy-Assisted Microvascular Decompression for Trigeminal Neuralgia: The Prognostic Impact of Interposing Material

Endoscopy-Assisted Microvascular Decompression for Trigeminal Neuralgia: The Prognostic Impact of Interposing Material

Endoscopic transcanal middle ear surgery

Infranuchal Infrafloccular Approach to the More Vulnerable Segments of the Facial Nerve in Microvascular Decompressions for the Hemifacial Spasm

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