Commentary: Hemifacial Spam: Endoscopic Assistance in Facial Nerve Decompression With Lateral Spread Response Corroboration: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Scott Connors ◽  
Tarek Y El Ahmadieh ◽  
Salah G Aoun ◽  
Samuel L Barnett
Keyword(s):  
Facial Nerve ◽  
Lateral Spread ◽  
Nerve Decompression ◽  
Endoscopic Assistance ◽  
Lateral Spread Response ◽  
Facial Nerve Decompression

Hemifacial Spam: Endoscopic Assistance in Facial Nerve Decompression With Lateral Spread Response Corroboration: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Cameron J Brimley ◽  
Raghuram Sampath
Keyword(s):  
Facial Nerve ◽  
Symptomatic Improvement ◽  
Lateral Spread ◽  
Complex Case ◽  
Anterior Inferior Cerebellar Artery ◽  
Dramatic Improvement ◽  
Auditory Evoked Responses ◽  
Root Exit Zone ◽  
Endoscopic Assistance ◽  
Lateral Spread Response

Abstract This video depicts the case of a 48-yr-old female with 3 yr of progressive left hemifacial spasm (HFS) refractory to medication. Magnetic resonance imaging showed a large anterior inferior cerebellar artery (AICA) and also a labyrinthine artery loop around the facial nerve (FN) root exit zone. A large bony eminence was also noted in the superior and lateral aspects of the porous acousticus (PA). She preferred surgery if “cure” was possible in lieu of Botox injections. A left retro sigmoid craniotomy was performed with brainstem auditory evoked responses (BAERs) and FN monitoring along with lateral spread response (LSR) assessment. The large bony prominence was drilled in its lateral aspect. Despite this, visualization was still limited and therefore we utilized a 30-degree-angled endoscope to observe the vessels caudal and cranial to the FN. This view prompted us to then drill further at the PA to decompress the FN as well as mobilize the labyrinthine artery away from the nerve. The LSR showed a dramatic improvement when FN decompression was accomplished, and then a further improvement with arterial mobilization and Teflon pledget placement. The BAERS remained at baseline throughout. FN function and hearing were intact on postoperative clinical assessment. Her symptomatic improvement was recorded at 12 mo after surgery. This video illustrates a more complex case of microvascular decompression with skull base concepts and techniques. The patient provided consent for the procedure and use of her images and operative video for publication.

scholarly journals Endoscopic-Assisted Microvascular Decompression of Ectatic Vertebral Artery for Hemifacial Spasm: Operative Video and Technical Nuances

2019 ◽  
Vol 80 (S 03) ◽  
pp. S312-S313
Author(s):  
James K. Liu ◽  
Vincent N. Dodson
Keyword(s):  
Facial Nerve ◽  
Vertebral Artery ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Lateral Spread ◽  
Microsurgical Decompression ◽  
Root Exit Zone ◽  
Hearing Function ◽  
Endoscopic Assistance ◽  
Lateral Spread Response

In this operative video atlas manuscript, the authors demonstrate the operative nuances and surgical technique for endoscopic-assisted microvascular decompression of a large ectatic vertebral artery causing hemifacial spasm. A retrosigmoid approach was performed and a large ectatic vertebral artery was transposed away from the root exit zone of cranial nerve VII (Fig. 1). The lateral spread response disappeared, signifying adequate decompression of the facial nerve (Fig. 2). The use of endoscopic-assistance during the microsurgical decompression was very useful to confirm the origin and also the resolution of neurovascular conflict. Postoperatively, the patient experienced immediate resolution of hemifacial spasm with normal facial nerve and hearing function. Written consent was obtained from the patient to publish videos, photographs, and images from the surgery.The link to the video can be found at: https://youtu.be/RlMz44uCDCw.

Acute Otitis Media and Facial Paralysis in Children

1996 ◽  
Vol 105 (1) ◽  
pp. 58-62 ◽  
Author(s):  
Clark A. Elliott ◽  
George H. Zalzal ◽  
Wendy R. Gottlieb
Keyword(s):  
Facial Nerve ◽  
Otitis Media ◽  
Facial Paralysis ◽  
Acute Otitis Media ◽  
Complete Recovery ◽  
Rapid Improvement ◽  
Nerve Decompression ◽  
Complete Paralysis ◽  
Prolonged Recovery ◽  
Facial Nerve Decompression

We reviewed 10 children who presented with facial paralysis after the onset of acute otitis media. The objective of the study was to examine the outcome of facial paralysis in children with acute otitis media treated without facial nerve decompression. Two groups were identified: 8 patients with incomplete paralysis and 2 with complete paralysis. Seven of the 8 patients with incomplete paralysis had rapid return of function after myringotomy and intravenous antibiotics. The eighth patient had delayed recovery requiring 9 months before complete return of function. The 2 patients with complete paralysis required mastoidectomy to control otorrhea and fever after initial myringotomy and antibiotics. Both patients had a prolonged recovery requiring 3 and 7 months for complete recovery. Patients with incomplete paralysis generally show rapid improvement following wide myringotomy and antibiotic treatment. A more protracted recovery may be expected in patients with complete paralysis; excellent return of function is expected when mastoidectomy without facial nerve decompression is employed.

Transtemporal Facial Nerve Decompression

1963 ◽  
Vol 77 (6) ◽  
pp. 41
Author(s):  
Maurice Schiff ◽  
Martin Magi ◽  
Allan M. Warner
Keyword(s):  
Facial Nerve ◽  
Nerve Decompression ◽  
Facial Nerve Decompression

scholarly journals Facial Nerve Decompression After Temporal Bone Fracture—The Bangalore Protocol

2019 ◽  
Vol 10 ◽  
Author(s):  
Vijayendra Honnurappa ◽  
Vinay Kumar Vijayendra ◽  
Nilesh Mahajan ◽  
Miriam Redleaf
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Bone Fracture ◽  
Temporal Bone Fracture ◽  
Nerve Decompression ◽  
Facial Nerve Decompression
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