Hemifacial spasm: a long term follow-up of patients treated by posterior fossa surgery and facial nerve wrapping.

Sixteen patients with hemifacial spasm were treated by posterior fossa surgery and wrapping of sponge around their facial nerve. A good or excellent result has been obtained in fourteen of the sixteen cases, and in seven cases followed by four years or longer. Two patients had a mild recurrence of their hemifacial spasm after a cessation of their spasm for eighteen months and two years following surgery. Contrary to the experience of other authors a definite vascular abnormality was found in only four cases. In the other twelve cases circumferential fibrosis about the nerve is again proposed as a mechanism for the effectiveness of the procedure.