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Objective:This study is designed to demonstrate a relationship between reconstruction methods of the craniectomy site and the development of postoperative complications including headache, tinnitus, and operation site pain after microvascular decompression(MVD) in patients with hemifacial spasm. Methods:This study included 44 consecutive patients who underwent MVD due to hemifacial spasm from 1995 to 2001. Craniectomy site was reconstructed with only Gelfoam(group 1) in 20, the bone dust and Gelfoam(group 2) in 11, the bone chips and Gelfoam(group 3) in 13. Group 1, 2 were studied retrospectively and group 3 was studied prospectively on the postoperative complications. Results:Postoperatively, wound infection occurred in 3(6.8%), headache in 14(31.8%), operation site pain in 17(38.6%), tinnitus in 15(34.1%), hearing loss in 1(2.2%). Wound infection was noticed in 5% of group 1, 18.2% of group 2, and none of group 3. Headache developed in 45% of group 1, 27.3% of group 2, and 15.4% of group 3. Operation site pain was noticed in 50% of group 1, 27.3% of group 2, 15.4% of group 3. Tinnitus revealed in 45% of group 1, 18.2% of group 2, 30% of group 3. Conclusion:Reconstruction of the craniectomy site with the bone chips in patients with hemifacial spasm might have effects on diminution of the postoperative headache, operation site pain and wound infection. Key words:Microvascular decompression(MVD);Hemifacial spasm;Bone chip.