Forty patients with facial hyperkinesia (hemi-facial spasm and blepharospasm) were treated by selective extratemporal excision of facial nerve branches. Intraoperative bipolar faradic stimulation was used to detect the nerve branches which were particularly involved in the production of the spasm. Silver clips have been applied over the coagulated end of the proximal nerve stumps following section in order to avoid regeneration and to facilitate their radiologic identification if, in case of recurrence, subsequent chemical blocking of regenerated fibers should be necessary. The surgical follow-up results revealed that 80% of the patients with hemifacial spasm were still relieved from their disturbance at the end of the third postoperative year. A high rate of recurrence developed however in the group of patients with blepharospasm, leaving only 17% of the patients in a satisfactory condition three years following the operation.
Fisch U, Esslen E. The Surgical Treatment of Facial Hyperkinesia. Arch Otolaryngol. 1972;95(5):400–405. doi:10.1001/archotol.1972.00770080636002
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