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Hemifasial spazm tedavisinde uygulanan endoskopik mikrovasküler dekompresyon cerrahisi eğitimi için kadavra koyun başi modellerinin kullanilmasi

Yıl 2025, Cilt: 58 Sayı: 3, 111 - 114, 24.02.2026
https://izlik.org/JA74MF37CY

Öz

Amaç: Hemifasiyal Spazm (HS) yaşam kalitesini etkileyen bir durumdur. Yüzün tek taraflı istemsiz, tonik veya klonik kasılmaları olarak tanımlanır. Mikrovasküler dekompresyon (MVD) yedinci sinir üzerine vasküler bası var ise birinci seçenek tedavisidir. Son zamanlarda endoskop kullanılarak yapılmaya başlanmıştır. Çalışmamızdaki amaç full endoskopik MVD cerrahisi için gerekli becerilerin gelişimi için kadavra koyun başı modeli geliştirilmesidir.

Gereç ve Yöntem: Çalışmada kullanılan materyal, yerel bir kasaptan temin edilen 5 adet taze koyun başıdır. Cerrahi adımlar, koyun kafalarının posterioru cerraha bakacak şekilde konumlandırılması, oksipital kondilin 1 cm üzerinden kraniyektomi yapılması, dura materin açılması, serebellar dokunun tanımlanması ve mediale çekilmesi, endoskop kullanılarak sisternlerin ve ardından kraniyal sinirlerin tanımlanması ve mikrovasküler dekompresyonun simüle edilmesinden oluşmaktadır.

Bulgular: Koyun kafataslarıyla full endoskopik MVD cerrahisi simüle edilmiştir.

Sonuç: Endoskopik MVD cerrahisine aşina olmaya olanak sağlaması açısından kadavra koyun başı modellerinin kullanılması endoskopik cerrahi pratiği ve egitimi için faydalı olabilir.

Kaynakça

  • REFERENCES 1. Lu AY, Yeung JT, Gerrard JL, et al. Hemifacial spasm and neurovascular compression. Sci World J. 2014;2014:349319. doi:10.1155/2014/349319
  • 2. Gardner WJ, Miklos MV. Response of trigeminal neuralgia to decompression of sensory root; discussion of cause of trigeminal neuralgia. JAMA. 1959;170(15):1773-1776. doi:10.1001/ jama.1959.03010150019004
  • 3. Gardner WJ, Sava GA. Hemifacial spasm: a reversible pathophysiologic state. J Neurosurg. 1962;19(3):240-247. doi:10.3171/jns.1962.19.3.0240
  • 4. Wang A, Jankovic J. Hemifacial spasm: clinical findings and treatment. Muscle Nerve. 1998;21(12):1740-1747. doi:10.1002/ (SICI)1097-4598(199812)21:12<1740::AID-MUS23>3.0.CO;2-V
  • 5. Girard B, de Saint Sauveur G, Tatry M, et al. Hemifacial spasm: etiology and management]. J Fr Ophtalmol. 2021;44(4):382-390. doi:10.1016/j.jfo.2020.08.009
  • 6. El Refaee E, Marx S, Rosenstengel C, Baldauf J, Schroeder HWS. Arachnoid bands and venous compression as rare causes of hemifacial spasm: analysis of etiology in 353 patients. Acta Neurochir (Wien). 2020;162(1):211-219. doi:10.1007/s00701-019- 04132-8
  • 7. Sharma R, Garg K, Agarwal S, et al. Microvascular decompression for hemifacial spasm: a systematic review of vascular pathology, long term treatment efficacy and safety. Neurol India. 2017;65(3):493-505. doi:10.4103/neuroindia.NI_340_16
  • 8. Fukunaga A, Shimizu K, Yazaki T, Ochiai M. A recommendation on the basis of long-term follow-up results of our microvascular decompression operation for hemifacial spasm. Acta Neurochir (Wien). 2013;155(9):1693-1697. doi:10.1007/s00701- 013-1796-8
  • 9. Badr-El-Dine M, El-Garem HF, Talaat AM, Magnan J. Endoscopically assisted minimally invasive microvascular decompression of hemifacial spasm. Otol Neurotol. 2002;23(2):122-128. doi:10.1097/00129492-200203000-00004
  • 10. Zheng X, Zhang B, Shao D, et al. Fully endoscopic microvascular decompression for hemifacial spasm: a clinical study and analysis. Neurosurg Rev. 2024;47(1):83. doi:10.1007/s10143-024- 02308-z
  • 11. Aurich LA, Silva Junior LF, Monteiro FM, et al. Microsurgical training model with nonliving swine head: alternative for neurosurgical education. Acta Cir Bras. 2014;29(6):405-409. doi:10.1590/ s0102-86502014000600010
  • 12. Korotkov D, Abramyan A, Wuo-Silva R, Chaddad-Neto F. Cadaveric sheep head model for anterior clinoidectomy in neurosurgical training. World Neurosurg. 2023;175:e481-e491. doi:10.1016/j.wneu.2023.03.129
  • 13. Dalgic A, Caliskan M, Can P, et al. Experimental endoscopic cordotomy in the sheep model. Turk Neurosurg. 2016;26(2):286- 290. doi:10.5137/1019-5149.JTN.12229-14.1
  • 14. Korotkov DS, Pait√°n AF, Abramyan A, Chaddad Neto FEA. Sheep head cadaveric model for the transmeatal extensions of the retrosigmoid approach. Asian J Neurosurg. 2024;19(4):791- 804. doi:10.1055/s-0044-1790517
  • 15. Tufan H, Baris B, Mehmet T, Turgay P, Sebahattin C. Posterior fossa approach: microneurosurgical training model in cadaveric sheep. Turk Neurosurg. 2006;16(3):111-114.
  • 16. Al-Sharshahi ZF, Hoz SS, Alrawi MA, et al. The use of non-living animals as simulation models for cranial neurosurgical procedures: a literature review. Chin Neurosurg J. 2020;6:24. doi:10.1186/s41016-020-00203-3
  • 17. Yasargil MG. From the microsurgical laboratory to the operation theatre. Acta Neurochir (Wien). 2005;147(5):465-468. doi:10.1007/s00701-005-0495-5
  • 18. Sidhu RS, Park J, Brydges R, MacRae HM, Dubrowski A. Laboratory-based vascular anastomosis training: a randomized controlled trial evaluating the effects of bench model fidelity and level of training on skill acquisition. J Vasc Surg. 2007;45(2):343- 349. doi:10.1016/j.jvs.2006.10.047
  • 19. Haase J, Boisen E. Neurosurgical training: more hours needed or a new learning culture? Surg Neurol. 2009;72(1):89-95. doi:10.1016/j.surneu.2008.03.034
  • 20. Hicdonmez T, Hamamcioglu MK, Parsak T, Cukur Z, Cobanoglu S. A laboratory training model for interhemispheric-transcallosal approach to the lateral ventricle. Neurosurg Rev. 2006;29(2):159-162. doi:10.1007/s10143-005-0014-4
  • 21. Guo X, Zhang C, Li Y, et al. Fully endoscopic microvascular decompression for hemifacial spasm using improved retrosigmoid infrafloccular approach: clinical analysis of 81 cases. Oper Neurosurg (Hagerstown). 2022;23(1):40-45. doi:10.1227/ ons.0000000000000245
  • 22. Zalyalova ZA. Gemifatsial'nyi spazm [Hemifacial spasm]. Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(3):140-147. doi:10.17116/jnevro2020120031140
  • 23. Feng BH, Zhong WX, Li ST, Wang XH. Fully endoscopic microvascular decompression of the hemifacial spasm: our experience. Acta Neurochir (Wien). 2020;162(5):1081-1087. doi:10.1007/s00701-020-04248-2
  • 24. Zhu J, Sun J, Li R, Yu Y, Zhang L. Fully endoscopic versus microscopic vascular decompression for hemifacial spasm: a retrospective cohort study. Acta Neurochir (Wien). 2021;163(9):2417- 2423. doi:10.1007/s00701-021-04808-0
  • 25. Peng W, Zhao R, Guan F, et al. Fully endoscopic microvascular decompression for the treatment of hemifacial spasm, trigeminal neuralgia, and glossopharyngeal neuralgia: a retrospective study. BMC Surg. 2023;23(1):331. doi:10.1186/s12893-023- 02235-9
  • 26. Cai Q, Li Z, Guo Q, et al. Microvascular decompression using a fully transcranial neuroendoscopic approach. Br J Neurosurg. 2023;37(6):1375-1378. doi:10.1080/02688697.2023.2240552

Training for Endoscopic Microvascular Decompression Surgery Using Cadaveric Sheep Head Models for Hemifacial Spasm Treatment

Yıl 2025, Cilt: 58 Sayı: 3, 111 - 114, 24.02.2026
https://izlik.org/JA74MF37CY

Öz

Aim: Hemifacial Spasm (HFS) is a condition that significantly impacts quality of life. It is characterized by involuntary, tonic or clonic contractions on one side of the face. Microvascular decompression (MVD) is the primary treatment option when vascular compression on the seventh cranial nerve is present. Recently, endoscopic techniques have been introduced for this procedure. The aim of our study is to develop a sheep head cadaver model to facilitate the acquisition of necessary skills for fully endoscopic MVD surgery.

Material and Methods: The material used in the study was 5 fresh sheep heads, obtained from a local butcher. The surgical steps consist of positioning the sheep's heads with its posterior facing the surgeon, performing a craniectomy 1 cm above the occipital condyle, opening the dura mater, identifying the cerebellar tissue and retracting it medially, identifying the cisterns and then the cranial nerves using an endoscope, and simulating microvascular decompression.

Results: Fully endoscopic MVD surgery was successfully simulated using the sheep skulls.

Conclusion: The use of sheep head cadaver models may be beneficial for endoscopic surgical training and practice, as they provide a practical means for familiarization with endoscopic MVD techniques.

Kaynakça

  • REFERENCES 1. Lu AY, Yeung JT, Gerrard JL, et al. Hemifacial spasm and neurovascular compression. Sci World J. 2014;2014:349319. doi:10.1155/2014/349319
  • 2. Gardner WJ, Miklos MV. Response of trigeminal neuralgia to decompression of sensory root; discussion of cause of trigeminal neuralgia. JAMA. 1959;170(15):1773-1776. doi:10.1001/ jama.1959.03010150019004
  • 3. Gardner WJ, Sava GA. Hemifacial spasm: a reversible pathophysiologic state. J Neurosurg. 1962;19(3):240-247. doi:10.3171/jns.1962.19.3.0240
  • 4. Wang A, Jankovic J. Hemifacial spasm: clinical findings and treatment. Muscle Nerve. 1998;21(12):1740-1747. doi:10.1002/ (SICI)1097-4598(199812)21:12<1740::AID-MUS23>3.0.CO;2-V
  • 5. Girard B, de Saint Sauveur G, Tatry M, et al. Hemifacial spasm: etiology and management]. J Fr Ophtalmol. 2021;44(4):382-390. doi:10.1016/j.jfo.2020.08.009
  • 6. El Refaee E, Marx S, Rosenstengel C, Baldauf J, Schroeder HWS. Arachnoid bands and venous compression as rare causes of hemifacial spasm: analysis of etiology in 353 patients. Acta Neurochir (Wien). 2020;162(1):211-219. doi:10.1007/s00701-019- 04132-8
  • 7. Sharma R, Garg K, Agarwal S, et al. Microvascular decompression for hemifacial spasm: a systematic review of vascular pathology, long term treatment efficacy and safety. Neurol India. 2017;65(3):493-505. doi:10.4103/neuroindia.NI_340_16
  • 8. Fukunaga A, Shimizu K, Yazaki T, Ochiai M. A recommendation on the basis of long-term follow-up results of our microvascular decompression operation for hemifacial spasm. Acta Neurochir (Wien). 2013;155(9):1693-1697. doi:10.1007/s00701- 013-1796-8
  • 9. Badr-El-Dine M, El-Garem HF, Talaat AM, Magnan J. Endoscopically assisted minimally invasive microvascular decompression of hemifacial spasm. Otol Neurotol. 2002;23(2):122-128. doi:10.1097/00129492-200203000-00004
  • 10. Zheng X, Zhang B, Shao D, et al. Fully endoscopic microvascular decompression for hemifacial spasm: a clinical study and analysis. Neurosurg Rev. 2024;47(1):83. doi:10.1007/s10143-024- 02308-z
  • 11. Aurich LA, Silva Junior LF, Monteiro FM, et al. Microsurgical training model with nonliving swine head: alternative for neurosurgical education. Acta Cir Bras. 2014;29(6):405-409. doi:10.1590/ s0102-86502014000600010
  • 12. Korotkov D, Abramyan A, Wuo-Silva R, Chaddad-Neto F. Cadaveric sheep head model for anterior clinoidectomy in neurosurgical training. World Neurosurg. 2023;175:e481-e491. doi:10.1016/j.wneu.2023.03.129
  • 13. Dalgic A, Caliskan M, Can P, et al. Experimental endoscopic cordotomy in the sheep model. Turk Neurosurg. 2016;26(2):286- 290. doi:10.5137/1019-5149.JTN.12229-14.1
  • 14. Korotkov DS, Pait√°n AF, Abramyan A, Chaddad Neto FEA. Sheep head cadaveric model for the transmeatal extensions of the retrosigmoid approach. Asian J Neurosurg. 2024;19(4):791- 804. doi:10.1055/s-0044-1790517
  • 15. Tufan H, Baris B, Mehmet T, Turgay P, Sebahattin C. Posterior fossa approach: microneurosurgical training model in cadaveric sheep. Turk Neurosurg. 2006;16(3):111-114.
  • 16. Al-Sharshahi ZF, Hoz SS, Alrawi MA, et al. The use of non-living animals as simulation models for cranial neurosurgical procedures: a literature review. Chin Neurosurg J. 2020;6:24. doi:10.1186/s41016-020-00203-3
  • 17. Yasargil MG. From the microsurgical laboratory to the operation theatre. Acta Neurochir (Wien). 2005;147(5):465-468. doi:10.1007/s00701-005-0495-5
  • 18. Sidhu RS, Park J, Brydges R, MacRae HM, Dubrowski A. Laboratory-based vascular anastomosis training: a randomized controlled trial evaluating the effects of bench model fidelity and level of training on skill acquisition. J Vasc Surg. 2007;45(2):343- 349. doi:10.1016/j.jvs.2006.10.047
  • 19. Haase J, Boisen E. Neurosurgical training: more hours needed or a new learning culture? Surg Neurol. 2009;72(1):89-95. doi:10.1016/j.surneu.2008.03.034
  • 20. Hicdonmez T, Hamamcioglu MK, Parsak T, Cukur Z, Cobanoglu S. A laboratory training model for interhemispheric-transcallosal approach to the lateral ventricle. Neurosurg Rev. 2006;29(2):159-162. doi:10.1007/s10143-005-0014-4
  • 21. Guo X, Zhang C, Li Y, et al. Fully endoscopic microvascular decompression for hemifacial spasm using improved retrosigmoid infrafloccular approach: clinical analysis of 81 cases. Oper Neurosurg (Hagerstown). 2022;23(1):40-45. doi:10.1227/ ons.0000000000000245
  • 22. Zalyalova ZA. Gemifatsial'nyi spazm [Hemifacial spasm]. Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(3):140-147. doi:10.17116/jnevro2020120031140
  • 23. Feng BH, Zhong WX, Li ST, Wang XH. Fully endoscopic microvascular decompression of the hemifacial spasm: our experience. Acta Neurochir (Wien). 2020;162(5):1081-1087. doi:10.1007/s00701-020-04248-2
  • 24. Zhu J, Sun J, Li R, Yu Y, Zhang L. Fully endoscopic versus microscopic vascular decompression for hemifacial spasm: a retrospective cohort study. Acta Neurochir (Wien). 2021;163(9):2417- 2423. doi:10.1007/s00701-021-04808-0
  • 25. Peng W, Zhao R, Guan F, et al. Fully endoscopic microvascular decompression for the treatment of hemifacial spasm, trigeminal neuralgia, and glossopharyngeal neuralgia: a retrospective study. BMC Surg. 2023;23(1):331. doi:10.1186/s12893-023- 02235-9
  • 26. Cai Q, Li Z, Guo Q, et al. Microvascular decompression using a fully transcranial neuroendoscopic approach. Br J Neurosurg. 2023;37(6):1375-1378. doi:10.1080/02688697.2023.2240552
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Beyin ve Sinir Cerrahisi (Nöroşirurji), Sinirbilim (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Ömer Şahin 0000-0001-9689-0068

Gönderilme Tarihi 26 Mart 2025
Kabul Tarihi 4 Ekim 2025
Yayımlanma Tarihi 24 Şubat 2026
DOI https://doi.org/10.20492/aeahtd.1665850
IZ https://izlik.org/JA74MF37CY
Yayımlandığı Sayı Yıl 2025 Cilt: 58 Sayı: 3

Kaynak Göster

AMA 1.Şahin Ö. Training for Endoscopic Microvascular Decompression Surgery Using Cadaveric Sheep Head Models for Hemifacial Spasm Treatment. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2026;58(3):111-114. doi:10.20492/aeahtd.1665850