Yamamoto Yu, Hashikata Hirokuni, Toda Hiroki, Iwasaki Koichi
Department of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, Osaka, Japan.
Department of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, Osaka, Japan; Department of Neurosurgery, Fukui Red Cross Hospital, Fukui, Japan.
World Neurosurg. 2019 Feb;122:491-494. doi: 10.1016/j.wneu.2018.11.126. Epub 2018 Nov 23.
The course of the anterior inferior cerebellar artery (AICA) in the cerebellopontine angle may affect the technical options in microvascular decompression surgery for hemifacial spasm. A complex relationship between the AICA and the nervus intermedius has rarely been discussed in patients with hemifacial spasms.
A 74-year-old woman presented with left facial spasms for 8 years. Intraoperative endoscopic observation confirmed that the left nervus intermedius crossed over the left AICA and limited its mobilization from the root exit zone (REZ) of the left facial nerve. Nervus intermedius section enabled mobilization of the AICA to decompress the facial nerve REZ. Her hemifacial spasm was resolved completely after the surgery with no significant complication.
The AICA may be found between the nervus intermedius and the facial nerve proper in patients with hemifacial spasm. Endoscope can visualize the relationship between the AICA and the nervus intermedius. Nervus intermedius section is a useful option in case that the nervus intermedius limits adequate mobilization of the AICA from the facial nerve REZ.
小脑前下动脉（AICA）在桥小脑角的走行可能会影响面肌痉挛微血管减压手术的技术选择。AICA与中间神经之间的复杂关系在面肌痉挛患者中很少被讨论。
一名74岁女性，左侧面部痉挛8年。术中内镜观察证实，左侧中间神经跨过左侧AICA，并限制了其从左侧面神经根部出口区（REZ）的游离。切断中间神经可使AICA游离，从而对面神经REZ进行减压。术后其面肌痉挛完全缓解，无明显并发症。
在面肌痉挛患者中，AICA可能位于中间神经与面神经主干之间。内镜可观察到AICA与中间神经之间的关系。在中间神经限制AICA从面神经REZ充分游离的情况下，切断中间神经是一种有用的选择。
