• Mauro Suárez, Ernesto Ardisana, Juan F Villalonga, Matías Baldoncini, and Álvaro Campero.
• Laboratorio de Innovaciones Neuroquirúrgicas de Tucumán (LINT), Tucumán, Argentina. E-mail: mauro.suarez@udea.edu.co.
• Medicina (B Aires). 2024 Jan 1; 84 (6): 116511721165-1172.

IntroductionHemifacial spasm (HFS) is a rare condition, characterized by unilateral, paroxysmal and involuntary contraction of the muscles innervated by the facial nerve (FN). The most common cause is a vascular conflict in the exit zone of the FN. The objective of this work is to demonstrate the efficacy and safety of neurovascular decompression (NVD).Materials And MethodsRetrospective analytical study, patients operated on for NVD due to HFS (n: 48), from June 2005 to December 2023, using a retrosigmoid approach and clinical-radiological follow-up, whose intraoperative recording was with a 2D or 3D video system. Age, gender, time of evolution, side of the condition, use of botulinum toxin, intraoperative findings, postsurgical results and complications were evaluated.ResultsThe average age was 50 years, with 60% women. The right side was affected in 23 cases. The vessel most identified as causing the neurovascular conflict was the anterior inferior cerebellar artery in 48% of the cases. The clinical response was complete (disappearance of HFS) in 41 patients (85%), partial in 5 cases and null in 2 cases. Complications included transient deficits in 11 cases and permanent deficits in 2 cases.DiscussionMost of our patients with HFS (85%) obtained a total improvement, along with a low rate of permanent morbidity (4%) and no cases of mortality. NVD should be considered as the first line of treatment in patients with primary HFS with evidence of neurovascular conflict on MRI.

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