Teflon granulomas mimicking cerebellopontine angle tumors following microvascular decompression

Abstract

4 Laryngoscope, 127:715-719, 2017.

Polytetrafluoroethylene granuloma‐associated facial palsy following microvascular decompression

“…TG formation following MVD for management of trigeminal neuralgia has been extensively described, with surgical removal of the TG frequently resulting in relief of recurrent facial pain and numbness . In contrast, literature regarding TG occurring after treatment for HFS is limited to a handful of case reports . This difference can partially be explained by the overall greater incidence of trigeminal neuralgia as opposed to HFS.…”

“…Following resection, the patient had stable hearing function with improvement in facial function to HB II/VI. Finally, Deep et al report two cases of TG formation, one presented 4 years following MVD with a 3‐year history of progressive hearing loss, HB III/VI facial palsy, and diplopia. Surgical resection confirmed TG with no follow‐up reported.…”

“…The formation of Teflon granuloma (TG) following MVD for management of trigeminal neuralgia has been well described, with a reported incidence of 5.6% . Rarely has facial palsy been reported among patients who have undergone MVD for HFS with a Teflon pledget . We here describe a cohort of six patients with a remote history of MVD for HFS for which Teflon was used and who subsequently developed ipsilateral facial weakness.…”

The diagnosis and management of a vertebral artery loop causing cervical radiculopathy

“…A small (1cm 2 ) patch of the Dacron® vascular graft was placed between the nerve and VA in order to isolate the neural structure from the ongoing pulsation of the vessel ( Figure 3D) [20,21]. Classically implanted Teflon sponge was not used due to the well-documented risk of inflammatory giant-cell foreign body reaction [22][23][24]. No major technical difficulties nor severe bleeding were encountered during either procedure.…”

Necrotizing Teflon Granuloma After Microvascular Decompression and Gamma Knife

“…Although generally considered to be an inert substance, the Teflon implant used in microvascular decompression surgery has been implicated in rare instances of granuloma formation following implantation. [1][2][3][4][5][6][7] We report a case of a 77-year-old female with remote history of breast cancer and mastectomy who was referred to our center for evaluation and treatment of an unusual mass lesion located in the posterior fossa ( Figure 1). She had an onset of trigeminal neuralgia beginning in 2000 for which she underwent a microvascular decompression in 2006; a shredded Teflon felt implant was placed between the culprit superior cerebellar artery and the underlying trigeminal nerve root.…”