Subscribe to RSS
DOI: 10.1055/s-0034-1543957
Placement of Teflon Sponges in Microvascular Decompression Procedure for Treatment of Hemifacial Spasm
Publication History
13 March 2014
24 October 2014
Publication Date:
23 March 2015 (online)
Abstract
Background Hemifacial spasm (HFS) is generally treated by microvascular decompression (MVD). Inadequate separation of vessel and nerve or adhesive inflammation surrounding the nerve root may cause recurrence.
Objective To explore a method to reduce the incidence of adhesions and to ensure sufficient separation of the offending vessel and nerve during MVD.
Methods Fifty-one patients diagnosed with HFS were studied. During the MVD procedure, Teflon sponges were placed between the offending vessels and medulla oblongata to push compressing vessels away from the facial nerve without contacting the nerve.
Results Our method of placement of the Teflon sponge effectively shifts the compressing artery and ensures that both the Teflon sponge and offending vessels do not contact the root exit zone. This method also ensures that the Teflon sponge is fixed in place.
Conclusion The technique described for the treatment of HFS provides an effective, safe, and durable resolution to patient symptoms that minimizes surgical complications and may be useful in treating HFS.
-
References
- 1 Huh R, Han IB, Moon JY, Chang JW, Chung SS. Microvascular decompression for hemifacial spasm: analyses of operative complications in 1582 consecutive patients. Surg Neurol 2008; 69 (2) 153-157 ; discussion 157
- 2 Jannetta PJ, Abbasy M, Maroon JC, Ramos FM, Albin MS. Etiology and definitive microsurgical treatment of hemifacial spasm. Operative techniques and results in 47 patients. J Neurosurg 1977; 47 (3) 321-328
- 3 Colosimo C, Bologna M, Lamberti S , et al. A comparative study of primary and secondary hemifacial spasm. Arch Neurol 2006; 63 (3) 441-444
- 4 Nagata S, Matsushima T, Fujii K, Fukui M, Kuromatsu C. Hemifacial spasm due to tumor, aneurysm, or arteriovenous malformation. Surg Neurol 1992; 38 (3) 204-209
- 5 Park JS, Kong DS, Lee JA, Park K. Hemifacial spasm: neurovascular compressive patterns and surgical significance. Acta Neurochir (Wien) 2008; 150 (3) 235-241 ; discussion 241
- 6 Barker II FG, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 1996; 334 (17) 1077-1083
- 7 Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 1967; 26 (Suppl. 01) 159-162
- 8 Jannetta PJ. Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients. Neurochirurgia (Stuttg) 1977; 20 (5) 145-154
- 9 McLaughlin MR, Jannetta PJ, Clyde BL, Subach BR, Comey CH, Resnick DK. Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg 1999; 90 (1) 1-8
- 10 Bejjani GK, Sekhar LN. Repositioning of the vertebral artery as treatment for neurovascular compression syndromes. Technical note. J Neurosurg 1997; 86 (4) 728-732
- 11 Dannenbaum M, Lega BC, Suki D, Harper RL, Yoshor D. Microvascular decompression for hemifacial spasm: long-term results from 114 operations performed without neurophysiological monitoring. J Neurosurg 2008; 109 (3) 410-415
- 12 Masuoka J, Matsushima T, Kawashima M, Nakahara Y, Funaki T, Mineta T. Stitched sling retraction technique for microvascular decompression: procedures and techniques based on an anatomical viewpoint. Neurosurg Rev 2011; 34 (3) 373-379 ; discussion 379–380
- 13 Shigeno T, Kumai J, Endo M, Oya S, Hotta S. Snare technique of vascular transposition for microvascular decompression—technical note. Neurol Med Chir (Tokyo) 2002; 42 (4) 184-189 ; discussion 190
- 14 Feng B, Zheng X, Zhang W , et al. Surgical treatment of pediatric hemifacial spasm patients. Acta Neurochir (Wien) 2011; 153 (5) 1031-1035 ; discussion 1035
- 15 Yuan Y, Wang Y, Zhang SX, Zhang L, Li R, Guo J. Microvascular decompression in patients with hemifacial spasm: report of 1200 cases. Chin Med J (Engl) 2005; 118 (10) 833-836
- 16 Yamaki T, Hashi K, Niwa J , et al. Results of reoperation for failed microvascular decompression. Acta Neurochir (Wien) 1992; 115 (1–2) 1-7
- 17 Kureshi SA, Wilkins RH. Posterior fossa reexploration for persistent or recurrent trigeminal neuralgia or hemifacial spasm: surgical findings and therapeutic implications. Neurosurgery 1998; 43 (5) 1111-1117
- 18 De Ridder D, Møller A, Verlooy J, Cornelissen M, De Ridder L. Is the root entry/exit zone important in microvascular compression syndromes?. Neurosurgery 2002; 51 (2) 427-433 ; discussion 433–434
- 19 Leclercq TA, Hill CL, Grisoli F. Retromastoid microsurgical approach to vascular compression of the eighth cranial nerve. Laryngoscope 1980; 90 (6 Pt 1) 1011-1017
- 20 Ryu H, Yamamoto S, Sugiyama K, Nishizawa S, Nozue M. Neurovascular compression syndrome of the eighth cranial nerve. Can the site of compression explain the symptoms?. Acta Neurochir (Wien) 1999; 141 (5) 495-501
- 21 Møller AR. Vascular compression of cranial nerves: II: pathophysiology. Neurol Res 1999; 21 (5) 439-443
- 22 Tomii M, Onoue H, Yasue M, Tokudome S, Abe T. Microscopic measurement of the facial nerve root exit zone from central glial myelin to peripheral Schwann cell myelin. J Neurosurg 2003; 99 (1) 121-124
- 23 Campos-Benitez M, Kaufmann AM. Neurovascular compression findings in hemifacial spasm. J Neurosurg 2008; 109 (3) 416-420