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Teflon Might Be a Factor Accounting for a Failed Microvascular Decompression in Hemifacial Spasm: A Technical Note

Authors
  • Dou, Ning-Ning
  • Zhong, Jun
  • Liu, Ming-Xing
  • Xia, Lei
  • Sun, Hui
  • Li, Bin
  • Li, Shi-Ting
Type
Published Article
Journal
Stereotactic and Functional Neurosurgery
Publisher
S. Karger AG
Publication Date
Jun 02, 2016
Volume
94
Issue
3
Pages
154–158
Identifiers
DOI: 10.1159/000446192
PMID: 27251374
Source
Karger
Keywords
License
Green
External links

Abstract

Background: Although Teflon is widely adopted for microvascular decompression (MVD) surgery, it has never been addressed for failure analysis. This study analyzed the reasons for failed MVDs with emphasis on the Teflon sponge. Methods: Among the 685 hemifacial spasm cases between 2010 and 2014, 31 were reoperated on within a week because of unsatisfactory outcome, which was focused on in this study. Intraoperative findings regarding Teflon inserts of these repeat MVDs were reviewed. Results: Among the 38 without satisfactory outcomes, 31 underwent repeat MVDs, and they were all spasm free afterwards. Eventually, the final cure rate was 99.2%. It was found in the repeat MVDs that the failure was attributable to the Teflon insert in most of the cases (74.2%) directly or indirectly. It was caused by improper placement (47.8%), inappropriate size (34.8%) and unsuitable shape (17.4%) of the Teflon sponge. Conclusion: Although it is not difficult for an experienced neurosurgeon to discover a neurovascular conflict during the MVD process, the size, shape and location of the Teflon sponge should not be ignored. Basically, the Teflon insert is used to keep the offending artery away from the facial nerve root rather than to isolate it. Therefore, the ideal Teflon sponge should be just small enough to produce a neurovascular separation.

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