Knowledge, Attitudes, and Practices Toward Microvascular Decompression for Hemifacial Spasm Among Neurosurgeons: A Multicenter Cross-Sectional Study.

Objective: Hemifacial spasm (HFS) is a rare but significantly impactful neuromuscular disorder that affects patients' quality of life, yet research on healthcare providers' readiness to manage this condition remains limited. This study aims to investigate the knowledge, attitudes, and practices (KAP) toward microvascular decompression (MVD) for HFS among neurosurgeons. Methods: This multicenter cross-sectional study was conducted between May and June 2024, involving multiple institutions across Eastern China. Data were collected through a structured questionnaire, which included sociodemographic information and KAP scores of participants. Results: A total of 223 valid questionnaires were collected, 218 (97.76%) were males. Multivariable logistic regression analysis found that both higher knowledge scores (P = 0.013) and attitude scores (P = 0.001) were independently associated with positive practice. Path analysis showed that the presence of neurosurgical microsurgery equipment and instruments (P = 0.025), title (P < 0.001), past experience in diagnosis and treatment of HFS (P < 0.001), and past experience in MVD surgery for HFS (P < 0.001) had direct effects on knowledge. Knowledge (P < 0.001) had a direct effect on attitude. Further, knowledge (P < 0.001) and attitude (P < 0.001) had direct effects on practice. Conclusion: Based on these findings, we recommend prioritizing the establishment of well-equipped surgical facilities, developing structured training programs that particularly benefit less experienced surgeons, and implementing regular assessment and education initiatives to enhance both knowledge and attitudes among neurosurgeons performing MVD procedures.