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Background <p>Anterior inferior cerebellar artery (AICA) compression is a common cause of hemifacial spasm (HFS). Endoscopic-assisted microvascular decompression (eMVD) offers several advantages, including minimal invasiveness, wide viewing angles, and clear visualization.</p> Methods <p>The surgical procedure was performed under a four-step endoscopic technique. Step 1: A 0° endoscope was used to dissect the cerebellopontine cistern and release cerebrospinal fluid for decompression. Step 2: A 30° endoscope was employed to dissect the arachnoid around the facial nerve and expose the root exit zone (REZ). Step 3: The AICA was identified, carefully dissected, and transposed away from the REZ. Step 4: Adequate decompression and hemostasis were confirmed.</p> Conclusion <p>The four-step endoscopic approach can achieve effective decompression in cases of HFS caused by AICA compression, providing favorable surgical outcomes.</p>

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How i do it: endoscopic transposition technique for hemifacial spasm caused by AICA compression

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月3日

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  • Wei Zhang,
  • Fuminari Komatsu,
  • Yoko Kato

摘要

Background

Anterior inferior cerebellar artery (AICA) compression is a common cause of hemifacial spasm (HFS). Endoscopic-assisted microvascular decompression (eMVD) offers several advantages, including minimal invasiveness, wide viewing angles, and clear visualization.

Methods

The surgical procedure was performed under a four-step endoscopic technique. Step 1: A 0° endoscope was used to dissect the cerebellopontine cistern and release cerebrospinal fluid for decompression. Step 2: A 30° endoscope was employed to dissect the arachnoid around the facial nerve and expose the root exit zone (REZ). Step 3: The AICA was identified, carefully dissected, and transposed away from the REZ. Step 4: Adequate decompression and hemostasis were confirmed.

Conclusion

The four-step endoscopic approach can achieve effective decompression in cases of HFS caused by AICA compression, providing favorable surgical outcomes.