How I do it: sling transposition technique with biopatch and aneurysm clip for hemifacial spasm.

Abstract

Microvascular decompression (MVD) represents the only definitive and non-ablative treatment for hemifacial spasm (HS). Teflon is the most used interposing material because considered inert; nevertheless, it is not free from complications. We discuss and illustrate our method to resolve the neurovascular conflict accounting for HS through a sling transposition technique using aneurysm clip and biopatch in carefully selected cases. Several MVD procedures, including interposing and transposing techniques, have been proposed for HS, mainly selected according to surgeon's preference. We consider the described technique a definitive treatment, safe, not associated to pain recurrence and without needing revision surgery.