title: A "sling swing transposition" technique with pedicled dural flap for microvascular decompression in hemifacial spasm.
abstract: BACKGROUND
  The key to successful microvascular decompression of the neurovascular compression syndrome is maintaining the separation between the nerve and the offending vessel.
  
  
  OBJECTIVE
  We describe a transposition technique in which a local pedicled dural flap, fashioned from the petrous posterior surface, is used to retract the offending vessel away from the root exit zone of the facial nerve in hemifacial spasm cases.
  
  
  METHODS
  We conducted a retrospective review of microvascular decompression operations in which the offending vessel was transposed and then retained by a local pedicled dural flap made from the dura of the petrous posterior surface.
  
  
  RESULTS
  This technique was used in 7 consecutive cases of the most recently operated series. Postoperatively, complete symptom relief was achieved in 100% of the patients without any significant surgical complications.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report in which an autologous anatomic structure in the cerebellopontine angle, such as petrous dura mater, is used in the microvascular decompression of the facial nerve. This is a simple yet robust method and can be considered an option for the treatment of hemifacial spasm caused by arterial compression.
authors.affiliation: Department of Neurosurgery, Osaka University Medical School, Suita, Osaka, Japan.
authors.forename: Hui Ming
authors.initials: HM
authors.lastname: Khoo
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
authors.forename: Takuyu
authors.initials: T
authors.lastname: Taki
mesh_terms: D000328:Adult; D000368:Aged; D002530:Cerebellopontine Angle / Q000601:surgery; D004388:Dura Mater / Q000601:surgery*; D005155:Facial Nerve Diseases / Q000150:complications / Q000601:surgery*; D005260:Female; D019569:Hemifacial Spasm / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps