Bioglue-Coated Teflon Sling Technique in Microvascular Decompression for Hemifacial Spasm Involving the Vertebral Artery.
10.3340/jkns.2016.59.5.505
- Author:
Seong Ho LEE
1
;
Jae Sung PARK
;
Young Hwan AHN
Author Information
1. Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea. yhahn00@naver.com
- Publication Type:Original Article
- Keywords:
Hemifacial spasm;
Vertebral artery;
Microvascular decompression;
Sling;
Teflon;
Bioglue
- MeSH:
Arteries;
Cerebrospinal Fluid;
Deafness;
Female;
Follow-Up Studies;
Hemifacial Spasm*;
Humans;
Male;
Microvascular Decompression Surgery*;
Polytetrafluoroethylene*;
Prospective Studies;
Recurrence;
Therapeutic Uses;
Vertebral Artery*
- From:Journal of Korean Neurosurgical Society
2016;59(5):505-511
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Microvascular decompression (MVD) for hemifacial spasm (HFS) involving the vertebral artery (VA) can be technically challenging. We investigated the therapeutic effects of a bioglue-coated Teflon sling technique on the VA during MVD in 42 cases. METHODS: A bioglue-coated Teflon sling was crafted by the surgeon and applied to patients in whom neurovascular compression was caused by the VA. The radiologic data, intra-operative findings with detailed introduction of the procedure, and the clinical outcomes of each patient were reviewed and analyzed. RESULTS: The 42 patients included in the analysis consisted of 22 females and 20 males, with an average follow-up duration of 76 months (range 24–132 months). Intraoperative investigation revealed that an artery other than the VA was responsible for the neurovascular compression in all cases : posterior inferior cerebellar artery (PICA) in 23 patients (54.7%) and anterior inferior cerebellar artery (AICA) in 11 patients (26.2%). All patients became symptom-free after MVD. Neither recurrence nor postoperative neurological deficit was noted during the 2-year follow-up, except in one patient who developed permanent deafness. Cerebrospinal fluid (CSF) leak occurred in three patients, and one required dural repair. CONCLUSION: Transposition of the VA using a bioglue-coated Teflon sling is a safe and effective surgical technique for HFS involving the VA. A future prospective study to compare clinical outcomes between groups with and without use of this novel technique is required.
