Facial spasm is a common disorder of the facial nervous system characterized by involuntary twitching and spasm of the facial muscles. It is mostly caused by vertebral artery branches, such as the anterior inferior cerebellar artery or the posterior inferior cerebellar artery, compressing the facial nerve root; A small number of patients with facial muscle spasm are directly compressed by the vertebral artery or pushed its branches to compress together, the operation of this kind of facial muscle spasm patients is more difficult, in the MVD operation, for different compression situations, it is necessary to take the correct treatment according to the actual situation, and to have an in-depth understanding of the anatomical structure and function of the pontine cerebellar angle, vertebral artery and its branches, to ensure the safety and effectiveness of the operation.
1.The surgical incision and bone window can be slightly lower to facilitate the management of the vertebral artery from below the posterior cranial nerve;
2.The arachnoid of the cranial nerve, choroid plexus, pom-pom and facial nerve root in the posterior group was fully released to increase the space for exposure and operation, and also to provide greater space for vertebral artery displacement.
3.Investigate below the root of the facial nerve to find the vertebral artery and the vertebral artery branch that compresses the facial nerve with it, fully release the responsible blood vessels, and prepare for displacement;
4.The fine forceps cooperate with the suction device to lift the vertebral artery branch, then adjust the direction of traction, lift the vertebral artery together, and then insert a slightly larger pad cotton to fix the displaced responsible blood vessel and relieve its compression on the opposite facial nerve;
The cotton pads should be kept away from the root of the facial nerve, which can reduce the chance of long-term** and hearing loss;