en تخصصي Special مروری Review Article <span style="font-size:11pt"><span style="line-height:150%"><span sans-serif="" style="font-family:Calibri,"><span style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">Hemifacial spasm (HFS) is an important condition for plastic surgeons to understand, as it significantly affects patients&#39; quality of life and can complicate aesthetic and reconstructive procedures. Magnetic resonance imaging (MRI) has become vital in diagnosing HFS, assessing neurovascular relationships, and planning treatment. Transverse MRI scans often show an upward displacement of the inferior pons at the facial nerve attachment point, signaling neurovascular compression (NVC) in HFS. Important anatomical features for neurosurgeons include cerebellar atrophy and a &quot;small posterior fossa,&quot; which can lead to HFS by narrowing fluid spaces. The posterior fossa is often more congested in HFS patients, and anatomical flatness may exacerbate lateral deviation of the vertebrobasilar arteries. Additionally, evaluating sigmoid sinus dominance and other anatomical variations is crucial for surgical planning, particularly in cases of arterial hypertension that may affect medullary compression.</span></span></span></span></span></span><br> &nbsp; facial nerve, Botulinum neurotoxin, Microvascular decompression surgery, Neurovascular compression syndrome, Plastic surgery 14 22 http://wjps.ir/browse.php?a_code=A-10-840-8&slc_lang=en&sid=1 Mohammad Bahadoram 100319475328460016171 100319475328460016171 Yes Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Esma’il Akade 100319475328460016172 100319475328460016172 No Department of Medical Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Seyed Ehsan Mohammadianinejad 100319475328460016173 100319475328460016173 No Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Shana Ahadi 100319475328460016174 100319475328460016174 No Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mohammad Davoodi 100319475328460016175 100319475328460016175 No Department of Radiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran