A New Application of Gelatin Sponge in the Treatment of Hemifacial Spasm by Microvascular Decompression: A Technical Note

Abstract

Objectives Microvascular decompression (MVD) for facial nerve remains the highly efficient hemifacial spasm (HFS) treatment. Nonetheless, a variety of cases have poor response to MVD. Using Teflon plus gelatin sponge in MVD seems to be a good solution. No existing study has examined the efficacy of using Teflon combined with gelatin sponge during MVD for HFS. Therefore, this study aimed to compare the efficacy of Teflon combined with gelatin sponge in HFS patients relative to that of Teflon alone. Patients and Methods We retrospectively compared the follow-up results of patients treated with Teflon and gelatin sponge with those treated with Teflon alone previously. Six hundred and eighty-eight primary HFS patients undergoing surgery from January 2010 to January 2018 were retrospectively analyzed. Three hundred and forty-seven cases received simple Teflon, while 342 cases underwent Teflon combined with gelatin sponge. Results In the Teflon plus gelatin sponge group, the incidences of facial palsy and hearing loss at 1 day, 1 year, and 2 years following surgery was significantly lower than those in the simple Teflon group. Differences in the success rates between Teflon plus gelatin sponge and the simple Teflon group were not statistically significant at 1 day, 1 year, and 2 years after surgery. The recurrence rate in the Teflon plus gelatin sponge group was significantly lower at 2 years. Conclusion For HFS patients undergoing MVD, using Teflon plus gelatin sponge can remarkably reduce the incidence of recurrence, facial palsy, and hearing loss compared with those using Teflon alone.

Fully endoscopic microvascular decompression for trigeminal neuralgia: technical note and early outcomes

“…[24,32] Recently, our department demonstrated that placing the moist gelatin sponge between Te on sponge and the facial nerve could remarkably reduce the incidence of hemifacial spasm recurrence. [7] We speculate that it will play the same role in reducing the incidence of TN recurrence because Te on adhesion and its granuloma development were also the cause of TN recurrence, although there is no study report the outcome of this method in TN MVD.…”

Bibliometric analysis of studies on the treatment of hemifacial spasm

“…The bibliometric analysis revealed that more researchers were concerned about the therapy of HFS. Recently, some investigators delivered articles about MVD in treating HFS ( 18 – 20 ), some studied the utilization of BoNT ( 21 , 22 ), some researchers have published a randomized controlled trial on the treatment of HFS ( 23 ), and some employed a meta-analysis ( 24 ). However, a few papers were using VOSviewer to analyze the trends or hotspots of HFS.…”