Prosthetic material degeneration over time as a possible factor in delayed recurrence of hemifacial spasm after successful microvascular decompression

Kondo, Akihide; Akiyama, Osamu; Suzuki, Mario; Arai, Hajime

doi:10.4103/sni.sni_146_18

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…An essential technique to obtain a successful result in cranial nerve compression syndrome is placing a prosthesis with no contact with the nerve root [ 18 ]. The sling technique is reported to be a more efficient method than the conventional interposition technique (inserting shredded Teflon pledgets on the REZ) because the REZ is isolated from any contacting object [ 3 – 5 , 8 , 22 ]. In a narrow operative field with a large VA, however, passing through a Teflon sling around the vessels has potential risks of damaging cranial nerves and perforators.…”

Section: Discussionmentioning

confidence: 99%

Bridge technique for hemifacial spasm with vertebral artery involvement

et al. 2021

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Background To assess efficacy and safety of a newly developed decompression technique in microvascular decompression for hemifacial spasm (HFS) with vertebral artery (VA) involvement. Methods A rigid Teflon (Bard® PTFE Felt Pledget, USA) with the ends placed between the lower pons and the flocculus creates a free space over the root exit zone (REZ) of the facial nerve (bridge technique). The bridge technique and the conventional sling technique for VA-related neurovascular compression were compared retrospectively in 60 patients. Elapsed time for decompression, number of Teflon pieces used during the procedure, and incidences of intraoperative manipulation to the lower cranial nerves were investigated. Postoperative outcomes and complications were retrospectively compared in both techniques. Results The time from recognition of the REZ to completion of the decompression maneuvers was significantly shorter, and fewer Teflon pieces were required in the bridge technique than in the sling technique. Lower cranial nerve manipulations were performed less in the bridge technique. Although statistical analyses revealed no significant differences in surgical outcomes except spasm-free at postoperative 1 month, the bridge technique is confirmed to provide spasm-free outcomes in the long-term without notable complications. Conclusions The bridge technique is a safe and effective decompression method for VA-involved HFS.

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Section: Discussionmentioning

confidence: 99%

Bridge technique for hemifacial spasm with vertebral artery involvement

et al. 2021

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“…It has been attested that a granuloma developed at the site could be a new culprit accounting for the recurrence. [ 17 – 19 ] Therefore, as long as the offending artery can be kept detaching from the nerve following an appropriate dissection, the Teflon could be waived even. Retracting blades are also unnecessary because a narrow suction tip on a padding cottonoid actually affords more room than a wider spatula does at the moment when a local area is being dissected.…”

Section: No Unnecessary Instrumentmentioning

confidence: 99%