Surgical Treatments of Hemifacial Spasm and Blepharospasm

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Surgical treatments of hemifacial spasm and blepharospasm have been reviewed. These conditions have been treated in the past by nerve block, radiofrequency coagulation, complete or partial section of the nerve, anastomosis and by neurovascular decompression. There are two methods with good hope of permanent relief of spasm. One is neurovascular decompression at the facial nerve root exit zone, and the other is hypoglossofacial anastomosis. The former relatively extensive operation has disadvantage of sensorineural hearing loss as the major complication. The latter is not popular for the unnatural facial expression after a long lasting complete facial paralysis by the operation.Other methods have by no means final solution, and recurrence pushes into submitting to repeated treatments. The history of neurectomy tells that very wide avulse of the temporal and buccal branches is mandatory to get satisfactory results for the patients. Non invasive nerve block has disadvantages of facial palsy of unpredictable period and the recurrence.No surgical treatments is perfect. Comprehenssive discussion with the patient is necessary prior to surgical procedures.
耳鼻咽喉科臨床学会の論文