• Jae-Young Kim, Shin Jung, Tae-Wook Song, In-Young Kim, Kyung-Sub Moon, Tae-Young Jung, and Woo-Youl Jang.
• Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital and Medical School, Gwangju, South Korea.
• World Neurosurg. 2019 Jun 1; 126: e94-e100.

BackgroundMicrovascular decompression surgery is the most effective treatment for hemifacial spasm (HFS). The vertebral artery (VA) is a larger and more elastic vessel, which makes surgical management more difficult. We introduce a surgical technique of proximal Teflon transposition with interposition (PTTI) in the vertebromedullary space for HFS with a VA offender.MethodsIn 112 patients with HFS, 22 patients had a VA offender on the facial nerve exit zone. Six of 22 patients with a VA offender underwent surgery by traditional microvascular decompression at the facial nerve exit zone, and 16 patients underwent the PTTI technique. We compared surgical outcomes of the PTTI technique and the conventional technique for HFS associated with the VA. We also compared surgical outcomes of the PTTI technique with outcomes of other alternative techniques.ResultsThe PTTI technique was associated with a good operative prognosis and fewer complications. The PTTI technique is an easy, safe, and effective method for treatment of patients with HFS with a VA offender.ConclusionsThe PTTI technique can be considered as another treatment option in addition to the transposition technique reported previously.Copyright © 2019 Elsevier Inc. All rights reserved.

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