Spasme de l’hémiface La chirurgie apporte une guérison dans la majorité des cas

Hemifacial spasm was for a long time an unknown and enigmatic affection. Nowadays, the cause has been clearly identified: a vascular conflict with the facial nerve. Magnetic Resonance Imaging assesses the diagnosis showing the artery responsible of the conflict. Endoscopic assisted surgery of the cerebellopontine angle (CPA) allows a precise localization of the conflict and simplifies the surgical procedure. In the period between October 1993 to February 2010, we operated 662 patients suffering from CPA neurovascularconflict, among them 439 cases of hemifacial spasm. All patients were operated by retrosigmoid approach using CPA endoscopy and facial nerve monitoring. Over our experience we discuss the pathogenic, diagnostic and therapeutic aspects of this affection. Key words: hemifacial spasm, neurovascular conflict, magnetic resonance imaging, CPA endoscopy, retrosigmoid approach, facial nerve monitoring