Microvascular Decompression for Hemifacial Spasm without the Use of Neuromonitoring and Fix Retraction: A Single-Center Experience.

Aim: To evaluate outcome of patients with hemifacial spasm surgically treated by microvascular decompression without the use of neuromonitoring and fix retraction.

Material and methods: Of the 78 patients with hemifacial spasm operated by the senior author of this study between 2016 and 2020, 60 patients who were followed up were included and retrospectively investigated. The female:male ratio was 32:28, and the mean age was 42.5 ± 11.5 years (range 23?71 years). All the patients were operated via the lateral retrosigmoid suboccipital infrafloccular approach, and no permanent retractor was employed during the procedures. Additionally, intraoperative neuromonitoring was not performed for any of the patients.

Results: Single vessel compression was observed in 77% of the patients, whereas 16% and 6% experienced compression in two and three vessels, respectively. Immediate recovery was achieved in 70% of the patients. Half of the remaining 30% fully recovered within 6 months?2 years. Furthermore, the complaints of 5% of the patients were alleviated, whereas no improvement was observed in 10% of the patients. One patient developed a recurrence.

Conclusion: Microvascular decompression is a highly effective method for the treatment of hemifacial spasm. In this study, we did not resort to intraoperative neuromonitoring and observed that our postoperative complication rates were consistent with the existing literature.