Lateral basal approach with a supine, no-retractor method for microvascular decompression for hemifacial spasm.

BACKGROUND: We describe the details of our unique surgical procedures for microvascular decompression for hemifacial spasm. METHODS: A patient is just laid supine, skipping the complicated preparation for the lateral or park-bench position. The subfloccular approach from a small cranial window situated on the more lateral and basal side of the occipital cranium enables the surgeon to reach all the segments of the facial nerve root without cerebellar retraction by a spatula. CONCLUSIONS: We believe this approach is ideal for the safe and precise decompression of any part of the facial nerve root.