To summarize and analyse the experience of microvascular decompression (MVD) in the treatment of hemifacial spasm (HPS).

Four hundred and fourteen patients with HFS, admitted by neurosurgery department of The People’s Hospital of Liaoning Province from January 2017 to December 2018, were analysesed retrospectively. All of the patients underwent MVD procedure. The efficiency and incidence of complication of postoperation were collected.

The follow-up time ranged from 18 to 52 months in all patients (mean 40.8 months). There were no deaths. The instant efficiency was 98.07% (406/414). The postoperative complications mainly include hearing loss, tinnitus, vertigo, delayed facial paralysis and cerebrospinal fluid fistula, but most of them were transient. Most of the offending vessels were posterior inferior cerebellar artery, followed by anterior inferior cerebellar artery and vertebral artery. After follow-up, the long term efficiency was 99.03% (410/414). The long term complications mainly include hearing loss, total hearing loss and tinnitus. Up to date, there was no recurrent patient in this study.

MVD is a safe and effective method to treat HFS. Mastering the technology skillfully, manipulating properly during procedures and preventing from postoperative complications carefully lay the foundation for a successful MVD operation.