Improved Microvascular Decompression in Treating Trigeminal Neuralgia: Application of Nest-Shaped Teflon Fibers

World Neurosurg. 2018 Feb:110:e1-e5. doi: 10.1016/j.wneu.2017.09.138. Epub 2017 Sep 28.

Abstract

Objective: To develop an improved technique for microvascular decompression (MVD) surgery using nest-shaped Teflon fibers.

Methods: Eighteen consecutive patients with trigeminal neuralgia (TN) who underwent MVD using nest-shaped Teflon fibers between January 2012 and December 2013 were included in this investigation. During the surgery, the Teflon prosthesis was formed into a nest shape by gently pushing it from the center toward the periphery. Immediate postoperative outcomes were evaluated using a numerical rating scale score, and patients were followed up for recurrence.

Results: Immediately after the surgery, pain was completely relieved in 16 patients (88.9%) and partially relieved in 2 patients (11.1%). Seven patients (38.9%) developed postoperative complications. All complications were successfully mitigated before discharge. The patients were followed up for 2.0-3.4 years. During follow-up, recurrence was observed in 2 patients (11.1%). No Teflon adhesion or Teflon-induced granuloma was found.

Conclusions: The nest-shaped Teflon fibers in MVD surgery for TN is safe and applicable. The long-term outcomes and the comparison between hollow nest-shaped implants and the standard cigar-shaped implants should be assessed in future investigations with larger sample sizes.

Keywords: Microvascular decompression; Nest shape; Teflon; Trigeminal neuralgia.

MeSH terms

  • Adult
  • Blood Vessel Prosthesis*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Microvascular Decompression Surgery* / methods
  • Middle Aged
  • Polytetrafluoroethylene
  • Postoperative Complications
  • Prosthesis Design
  • Recurrence
  • Treatment Outcome
  • Trigeminal Neuralgia / diagnostic imaging
  • Trigeminal Neuralgia / surgery*

Substances

  • Polytetrafluoroethylene