Ahead of Print: Sling Swing Transposition for MVD
Background: The key to successful microvascular decompression of the neurovascular compression syndrome is maintenance of the separation between the nerve and the offending vessel.
Objective: We describe a transposition technique whereby a local pedicleddural flap, fashioned from the petrous posterior surface, is utilized to retract the offending vessel away from the root exit zoneof the facial nerve in hemifacial spasmcases.
Methods: We conducted a retrospective review of microvascular decompressionoperations in which the offending vessel was transposed and then retained by a localpedicleddural flap, made from the dura of the petrous posterior surface.
Results: This technique was used in 7 consecutive cases of the most recently operated series. Postoperatively, complete symptom relief was achieved in 100% of the patients without any significant surgical complications.
Conclusion: To our knowledge, this is the first report in which anautologous anatomic structure in the cerebellopontine angle, such as petrous dura mater, is used in the microvascular decompression of the facial nerve. This is asimple yet robust method, and can be considered as an option for the treatment of hemifacial spasm due to arterial compression.
From: A “Sling Swing Transposition” Technique with Pedicled Dural Flap for Microvascular Decompression in Hemifacial Spasm by Khoo et al.
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