Endoscope-assisted microvascular decompression in hemifacial spasm with a teflon bridge

Background Microvascular conflicts in hemifacial spasm typically occur at the facial nerve’s root exit zone. While a pure microsurgical approach offers only limited orientation, added endoscopy enhances visibility of the relevant structures without the necessity of cerebellar retraction. Methods After a retrosigmoid craniotomy, a microsurgical decompression of the facial nerve is performed with a Teflon bridge. Endoscopic inspection prior and after decompression facilitates optimal Teflon bridge positioning. Conclusions Endoscope-assisted microsurgery allows a clear visualization and safe manipulation on the facial nerve at its root exit zone.