What question did this study set out to answer?

This research aims to detail an implant-free surgical technique for microvascular decompression to treat hemifacial spasm.

June 27, 2026Open Access

How I do it: Implant-free transposition technique for microvascular decompression in hemifacial spasm

MKMelanie KristtNewYork–Presbyterian Hospital RSRaymond F. SekulaNewYork–Presbyterian Hospital

Key Points

This research aims to detail an implant-free surgical technique for microvascular decompression to treat hemifacial spasm.
Describes a transposition technique using TachoSil ® during microvascular decompression.
Technique illustrated with a supporting video to aid understanding.
Focuses on appropriately selected patients for safe and effective outcomes.
Achieves spasm freedom in approximately 90% of hemifacial spasm cases.
Highlights potential advantages of TachoSil ® over traditional surgical materials and techniques.

Abstract

Hemifacial spasm (HFS) is most often caused by arterial compression of the facial nerve (CNVII). Microvascular decompression (MVD) of CNVII has excellent outcomes, achieving spasm freedom in approximately 90% of patients, and can be accomplished by inter positional or transpositional techniques. We present a step-by-step description of an experienced surgeon’s technique for MVD in HFS using vessel transposition with TachoSil ® , supported by an illustrative video. In our experience, transposition using TachoSil ® during MVD for HFS, in appropriately selected patients, is a safe and effective approach offering potential advantages over traditional materials and techniques.

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