Defining the target for hemifacial spasm –regarding microvascular decompression - Takeaways - MDSpire

Defining the target for hemifacial spasm –regarding microvascular decompression

  • By

  • Philip Kawalec

  • Anthony M. Kaufmann

  • May 12, 2026

  • 0 min

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  • 1

    The manuscript reviews the historical evolution of microvascular decompression (MVD) for cranial nerve disorders, emphasizing anatomical and physiological considerations.

  • 2

    Jannetta's neurovascular compression hypothesis identified the transition zone as the MVD target for trigeminal neuralgia and hemifacial spasm.

  • 3

    Matsushima et al. highlight the REZ as the focus for MVD, but the definition fails to adequately capture the central myelin section of the facial nerve.

  • 4

    An extensive analysis reveals the centrally myelinated portion of the facial nerve is longer than previously defined, necessitating a broader definition of the fREZ.

  • 5

    Adopting a comprehensive fREZ definition is crucial for successful MVD in hemifacial spasm, focusing on the proximal segments rather than distal facial nerve areas.

Original Source(s)

Defining the target for hemifacial spasm –regarding microvascular decompression

  • by Philip Kawalec, Anthony M. Kaufmann

  • May 12, 2026

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