We provide surgical treatment for hemifacial spasm. Hemifacial spasm is caused by vascular compression on the most sensitive part of the facial nerve (REZ). Microvascular decompression moves the artery away from the REZ, which leads to stabilize facial spasm. Same as trigeminal neuralgia, 3D preoperative imaging is very useful for hemifacial spasm as well. It is crucial that a surgeon should understand the anatomical relation between the facial nerve and adjacent cranial nerves and arteries. ■Microvascular Decompression for Hemifacial Spasm Precise preoperative imaging. Key hole surgery through a small skin incision. Transposition technique applied rather than interposition, which contributes to lower recurrence rate. No suture on the skin, which enables to early discharge from the hospital. Hospital stay is normally less than 4 days. 3D image for Hemifacial Spasm Facial nerve (blue) runs inside of Auditory nerve (yellow). An artery has a contact with the facial nerve REZ. Operative view Tortuous artery contacts facial nerve on its REZ. Operative view of Hemifacial Spasm Larger artery (Vertebral artery) can be a cause of hemifacial spasm Tortuous artery runs on the REZ Teflon felt is used for transposition of the artery. Takuro INOUE M.D., Ph.D. Chief Director, Neurosurgery, Kotoh Memorial Hospital 2015 Chief Director, visiting consultant Andalusia Hospital, Egypt 2010 to present Chief Director, Kotoh Memorial Hospital, Shiga, Japan 2007 Clinical training at Duke University, USA 2004 Gamma Knife training at Kalorinska University, Sweden 1998-2009 Neurosurgery, Hino Memorial Hospital, Shiga, Japan 1997-1998 University of British Columbia, Canada 1994-1996 Neurosurgery, Okamoto General Hospital, Kyoto, Japan 1992-1993 Neurosurgery, Saiseikai Noe Hospital, Osaka, Japan 1991-1992 Neurosurgery, University of Shiga Medical Science Hospital 2013 Skull Base Workshop, Chulalongkorn University, Thailand 2013 Asean Cerebrovascular Skull Base Hand On Course & Symposium, Chulalongkorn University, Thailand 2011 Advanced Skull Base Microanatomy Workshop and Hands-On Dissection Course, Florida, USA 2010 Advanced Skull Base Microanatomy Workshop and Hands-On Dissection Course, Florida, USA 2008 Cadaver Workshop on Skull Base, Aichi, Japan 2008 Cadaver Dissection Course, Kyoto, Japan For your reservation, E-mail subaru@gammaknife-c.jp or leave message here ▲UP

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