2026 Poster Presentations
P361: MINI ENDOSCOPIC ASSISTANCE IN FAILED MICROVASCULAR DECOMPRESSION FOR HEMIFACIAL SPASM
Hannah Weiss; Kristen Marciniuk; Aleksandar Beric; Athena Lolis; Adauri Bueno de Carmago; Erez Nossek; Donato Pacione; NYU Langone Health
We present an 83-year-old woman with hemifacial spasm who underwent right retrosigmoid microvascular decompression for PICA and AICA conflict. Initial surgery achieved partial improvement, with persistent upper-to-lower lateral spread. She developed recurrent periorbital spasm by postoperative day three and was re-explored on day four using a mini-endoscope (Colibri). A distal superior vascular conflict was identified and decompressed, resulting in complete and durable resolution. This case highlights the utility of endoscopic assistance in failed microvascular decompression.