Abordagem retrosigmóidea assistida por endoscopia em espasmo hemifacial: nossa experiência

Translated title of the contribution: Endoscope-assisted retrosigmoid approach in hemifacial spasm: our experience

Giampietro Ricci, Arianna Di Stadio, Luca D'Ascanio, Ruggero La Penna, Franco Trabalzini, Antonio della Volpe, Jacques Magnan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: The use of surgical decompression of facial hemispasm due to the loop in the internal auditory canal is not always accepted due to the risk related to the surgical procedure. Currently a new surgical technique allows surgeons to work in safer conditions. Objective: To report the results with endoscope-assisted retrosigmoid approach for facial nerve microvascular decompression in hemifacial spasm due to neurovascular conflict. The surgical technique is described. Methods: We carried out a prospective study in a tertiary referral center observing 12 (5 male, 7 female) patients, mean age 57.5 years (range 49–71) affected by hemifacial spasm, that underwent to an endoscope assisted retrosigmoid approach for microvascular decompression. We evaluated intra-operative findings, postoperative HFS resolution and complication rates. Results: Hemifacial spasm resolution was noticed in 9/12 (75%) cases within 24 h after surgery and in 12/12 (100%) subjects within 45 days. A significant (p < 0.001) correlation between preoperative historical duration of hemifacial spasm and postoperative recovery timing was recorded. Only 1 patient had a complication (meningitis), which resolved after intravenous antibiotics with no sequelae. No cases of cerebrospinal fluid leak, facial palsy or hearing impairment were recorded. Hemifacial spasm recurrence was noticed in the only subject where the neurovascular conflict was due to a vein within the internal auditory canal. Conclusions: The endoscope assisted retrosigmoid approach technique offers an optimal visualization of the neurovascular conflict thorough a minimally invasive approach, thus allowing an accurate decompression of the facial nerve with low complication rates. Due to the less invasive nature, the procedure should be considered in functional surgery of the cerebellar pontine angle as hemifacial spasm treatment, specially when the procedure is performed by an otolaryngologist.

Original languagePortuguese
Pages (from-to)465-472
Number of pages8
JournalBrazilian Journal of Otorhinolaryngology
Volume85
Issue number4
DOIs
Publication statusPublished - Jul 1 2019

Fingerprint

Hemifacial Spasm
Endoscopes
Microvascular Decompression Surgery
Facial Nerve
Surgical Decompression
Facial Paralysis
Decompression
Hearing Loss
Meningitis
Tertiary Care Centers
Veins
Prospective Studies
Anti-Bacterial Agents
Recurrence

Keywords

  • Endoscopic surgery
  • Facial nerve
  • Hemifacial spasm
  • Nerve decompression
  • Quality of life

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Abordagem retrosigmóidea assistida por endoscopia em espasmo hemifacial : nossa experiência. / Ricci, Giampietro; Di Stadio, Arianna; D'Ascanio, Luca; La Penna, Ruggero; Trabalzini, Franco; della Volpe, Antonio; Magnan, Jacques.

In: Brazilian Journal of Otorhinolaryngology, Vol. 85, No. 4, 01.07.2019, p. 465-472.

Research output: Contribution to journalArticle

Ricci, G, Di Stadio, A, D'Ascanio, L, La Penna, R, Trabalzini, F, della Volpe, A & Magnan, J 2019, 'Abordagem retrosigmóidea assistida por endoscopia em espasmo hemifacial: nossa experiência', Brazilian Journal of Otorhinolaryngology, vol. 85, no. 4, pp. 465-472. https://doi.org/10.1016/j.bjorl.2018.03.015
Ricci, Giampietro ; Di Stadio, Arianna ; D'Ascanio, Luca ; La Penna, Ruggero ; Trabalzini, Franco ; della Volpe, Antonio ; Magnan, Jacques. / Abordagem retrosigmóidea assistida por endoscopia em espasmo hemifacial : nossa experiência. In: Brazilian Journal of Otorhinolaryngology. 2019 ; Vol. 85, No. 4. pp. 465-472.
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abstract = "Introduction: The use of surgical decompression of facial hemispasm due to the loop in the internal auditory canal is not always accepted due to the risk related to the surgical procedure. Currently a new surgical technique allows surgeons to work in safer conditions. Objective: To report the results with endoscope-assisted retrosigmoid approach for facial nerve microvascular decompression in hemifacial spasm due to neurovascular conflict. The surgical technique is described. Methods: We carried out a prospective study in a tertiary referral center observing 12 (5 male, 7 female) patients, mean age 57.5 years (range 49–71) affected by hemifacial spasm, that underwent to an endoscope assisted retrosigmoid approach for microvascular decompression. We evaluated intra-operative findings, postoperative HFS resolution and complication rates. Results: Hemifacial spasm resolution was noticed in 9/12 (75{\%}) cases within 24 h after surgery and in 12/12 (100{\%}) subjects within 45 days. A significant (p < 0.001) correlation between preoperative historical duration of hemifacial spasm and postoperative recovery timing was recorded. Only 1 patient had a complication (meningitis), which resolved after intravenous antibiotics with no sequelae. No cases of cerebrospinal fluid leak, facial palsy or hearing impairment were recorded. Hemifacial spasm recurrence was noticed in the only subject where the neurovascular conflict was due to a vein within the internal auditory canal. Conclusions: The endoscope assisted retrosigmoid approach technique offers an optimal visualization of the neurovascular conflict thorough a minimally invasive approach, thus allowing an accurate decompression of the facial nerve with low complication rates. Due to the less invasive nature, the procedure should be considered in functional surgery of the cerebellar pontine angle as hemifacial spasm treatment, specially when the procedure is performed by an otolaryngologist.",
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