Surgical Principles of Hemifacial Spasm: How We Do Microvascular Decompression

Jannetta published his clinical outcome of microvascular decompression (MVD) in neurovascular compression syndrome. In that article, operative techniques were described in detail and his surgical guidance has been used in MVD neurosurgeons all around the world (McLaughlin et al. J Neurosurg 90:1–8, 1999). We also applied his surgical techniques as the fundamentals and succeeded them into our own methods and skills. Herein, we are going to share our principles of MVD surgery, especially in patients with hemifacial spasm. Although other positions, approaches, or techniques are feasible, we are confident that our way of performing MVD is efficient and safe based on our two decades of clinical outcomes. Step-by-step surgical guidance during MVD for HFS is described in detail as much as possible. And surgical tips are presented for performing a successful decompression and for avoiding complications in each step.