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BACKGROUND Microvascular decompression (MVD) is the surgical treatment of choice for hemifacial spasm (HFS). During MVD, monitoring of the abnormal lateral spread response (LSR), an evoked response to facial nerve stimulation, has been traditionally used to monitor adequacy of cranial nerve (CN) VII decompression. OBJECTIVE To assess the utility of LSR monitoring in predicting spasm-free status after MVD postoperatively. METHODS We searched PubMed, Web of Science, and Embase for relevant publications. We included studies reporting on i

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