To analyze the clinical effect of the offending vessel suspension technique in microvascular decompression (MVD) in the treatment of facial spasm.

The clinical data of 82 patients with facial spasm treated by MVD with the offending vessel suspension technique in the Neurosurgery Department of Nanjing Drum Tower Hospital from January to July 2018 were analyzed retrospectively, and the surgical effect and postoperative complications were recorded and analyzed.

The large heavy compressed conflicting vessel was found in 19 cases: 15 cases of vertebral artery associated with anterior inferior cerebellar artery (AICA), 3 cases with posterior inferior cerebellar artery (PICA), 1 case with AICA and PICA. The multiple vessels were found in 13 cases: 9 cases of AICA associated with PICA, 4 cases of the branches of AICA. An elongated loop was found in 20 cases. No decompression fulcrum or perforator with brainstem in 30 cases: 28 cases of AICA, 2 cases of PICA. Using the hanging technique, the permanent and complete transposition of the offending vessel was achieved. The immediate postoperative care rate was 96.3% (79/82) and the effective rate was 98.8% (81/82). The patients were followed up for 28 to 34 months, the care rate was 87.8% (72/82), and the effective rate was 97.6% (80/82), 3 cases of transient facial palsy and 3 cases of hearing loss.

The offending vessel suspension technique can be used as supplementary technique for traditional MVD of facial spasm, especially when the cotton pad alone can not fully decompress. This method is easily applied, reversible and with little damage. It is essential for making stable neurovascular relationship, to avoid recurrence and the complications.