Jho Institute for Minimally Invasive Neurosurgery Department of Neuroendoscopy
Spine Diseases
     Brain Diseases

Hemifacial Spasm: Dr. Jho's Endoscopic Micro-Vascular Decompression, Minimally Invasive Hemifacial Spasm surgery

Dr. Jho's Minimally Invasive Endoscopic Microvascular Decompression Surgery for Hemifacial Spasm

Professor & Chair,  Department of Neuroendoscopy
Jho Institute for Minimally Invasive Neurosurgery

     After working for approximately 20 years with Professor Jannetta (who pioneered the development of various Jannetta procedures for microvascular decompression), Dr. Jho developed minimally invasive endoscopic microvascular decompression surgery.  Microvascular decompression surgery was originally pioneered by Professor Jannetta, who has spent his lifetime in a neurosurgery career exploring various neurovascular compression syndromes.
     Microvascular decompression (which consists of placement of small synthetic sponges between the compressing blood vessels and the affected cranial nerves) carries a good chance of relieving cranial nerve compression symptoms such as hemifacial spasm.
     Cranial nerve surgery is done through a small skull opening behind the ear and is referred to as retromastoid craniectomy.  Skin incisions are usually two inches in length.  Surgery is performed under the endoscopic visualization.
     When blood vessels cross and compress cranial nerves, various characteristic symptoms develop depending upon which cranial nerves are compressed.  Trigeminal neuralgia develops by blood vessel compression of the trigeminal nerve, hemifacial spasm by compression of the facial nerve, intractable positional vertigo by compression of the vestibular nerve, tinnitus by compression of the cochlear nerve, glossopharyngeal neuralgia by compression on the glossopharyngeal nerve, and spasmodic torticollis by pressure on the spinal accessory nerve and upper cervical nerves.

    A:            B:
Figure 1. For microvascular decompression, a 4-cm skin incision is made behind the patient's ear (A).  An intraoperative photograph displays arterial compression of the facial nerve in a patient with hemifacial spasm (B).

For referral information or appointment for consultation contact:
                            Practice Manager:  Robin A. Coret
              e-mail : Drjho@ahn.org
                                       Tel : (412) 359-6110
                                     Fax : (412) 359-8339

         Address : JHO Institute for Minimally Invasive Neurosurgery
                            Department of Neuroendoscopy
                               Sixth Floor, South Tower
                               Allegheny General Hospital
                               320 East North Avenue
                               Pittsburgh, PA 15212-4772
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                    Dr. Jho via e-mail  Drjho@ahn.org
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