Hemifacial Spasm. Operative and Ultrastructural Findings.:-Operative and Ultrastructural Findings-
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Eight patients with idiopathic hemifacial spasm (HFS) were treated by surgery. Five of them (1985-1986) were treated with a total facial nerve decompression through a transmastoid and middle fossa approach combined with retrolabyrinthine microvascular decompression (MVD). A small amount of facial nerve tissue was taken from various portions in the temporal bone for electronmicroscopic evaluation in these cases. The other three patients (1990-1991) were treated by MVD through a suboccipital approach. One patient needed revision surgery, the other seven had an excellent clinical course without any complications. A definite vascular compression of the facial nerve at the root entry zone was identified in six patient. The ultrastructural findings suggested that the histological changes in the nerve tissue itself were not so severe as in Bell's palsy which needs decompression surgery. We concluded that MVD surgery by an experienced surgeon is the best treatment for HFS provided we can exclude secondary HFS.
- 耳鼻咽喉科臨床学会の論文
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