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http://dx.doi.org/10.3340/jkns.2016.59.5.505

Bioglue-Coated Teflon Sling Technique in Microvascular Decompression for Hemifacial Spasm Involving the Vertebral Artery  

Lee, Seong Ho (Department of Neurosurgery, Ajou University School of Medicine)
Park, Jae Sung (Department of Neurosurgery, School of Medicine, Konkuk University, Konkuk University Chungju Hospital)
Ahn, Young Hwan (Department of Neurosurgery, Ajou University School of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.59, no.5, 2016 , pp. 505-511 More about this Journal
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.
Keywords
Hemifacial spasm; Vertebral artery; Microvascular decompression; Sling; Teflon; Bioglue;
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1 Samii M, Gunther T, Iaconetta G, Muehling M, Vorkapic P, Samii A : Microvascular decompression to treat hemifacial spasm : long-term results for a consecutive series of 143 patients. Neurosurgery 50 : 712-718; discussion 718-719, 2002   DOI
2 Shigeno T, Kumai J, Endo M, Oya S, Hotta S : Snare technique of vascular transposition for microvascular decompression--technical note. Neurol Med Chir (Tokyo) 42 : 184-189; discussion 190, 2002   DOI
3 Shimano H, Kondo A, Yasuda S, Inoue H, Park YT, Murao K : Microvascular decompression for hemifacial spasm associated with bilateral vertebral artery compression. World Neurosurg 84 : 1178.e0005-1178.e0009, 2015
4 Sindou M, Leston JM, Decullier E, Chapuis F : Microvascular decompression for trigeminal neuralgia : the importance of a noncompressive technique--Kaplan-Meier analysis in a consecutive series of 330 patients. Neurosurgery 63 (4 Suppl 2) : 341-350; discussion 350-351, 2008
5 Thirumala P, Frederickson AM, Balzer J, Crammond D, Habeych ME, Chang YF, et al. : Reduction in high-frequency hearing loss following technical modifications to microvascular decompression for hemifacial spasm. J Neurosurg 123 : 1059-1064, 2015   DOI
6 Zaidi HA, Awad AW, Chowdhry SA, Fusco D, Nakaji P, Spetzler RF : Microvascular decompression for hemifacial spasm secondary to vertebrobasilar dolichoectasia : surgical strategies, technical nuances and clinical outcomes. J Clin Neurosci 22 : 62-68, 2015   DOI
7 Tomasello F, Alafaci C, Salpietro FM, Longo M : Bulbar compression by an ectatic vertebral artery : a novel neurovascular construct relieved by microsurgical decompression. Neurosurgery 56 (1 Suppl) : 117-124; discussion 117-124, 2005
8 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 69 : 153-157, 2008   DOI
9 Rawlinson JN, Coakham HB : The treatment of hemifacial spasm by sling retraction. Br J Neurosurg 2 : 173-178, 1988   DOI
10 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) 118 : 833-836, 2005
11 Montaner J, Alvarez-Sabin J, Rovira A, Molina C, Grive E, Codina A, et al. : [Vertebrobasilar abnormalities in patients with hemifacial spasm : MR-angiography findings]. Rev Neurol 29 : 700-703, 1999
12 Marneffe V, Polo G, Fischer C, Sindou M : [Microsurgical vascular decompression for hemifacial spasm. Follow-up over one year, clinical results and prognostic factors. Study of a series of 100 cases]. Neurochirurgie 49 : 527-535, 2003
13 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 34 : 373-379; discussion 379-380, 2011   DOI
14 McLaughlin MR, Jannetta PJ, Clyde BL, Subach BR, Comey CH, Resnick DK : Microvascular decompression of cranial nerves : lessons learned after 4400 operations. J Neurosurg 90 : 1-8, 1999   DOI
15 Bejjani GK, Sekhar LN : Repositioning of the vertebral artery as treatment for neurovascular compression syndromes. Technical note. J Neurosurg 86 : 728-732, 1997   DOI
16 Park JS, Kong DS, Lee JA, Park K : Hemifacial spasm : neurovascular compressive patterns and surgical significance. Acta Neurochir (Wien) 150 : 235-241; discussion 241, 2008   DOI
17 Park KD, Kim YI, Ahn YH : Cerebello-pontine angle lipoma causing hemifacial spasm. J Korean Soc Ster Func Neurosurg 10 : 37-40, 2014
18 Payner TD, Tew JM Jr : Recurrence of hemifacial spasm after microvascular decompression. Neurosurgery 38 : 686-690; discussion 690-691, 1996   DOI
19 Attabib N, Kaufmann AM : Use of fenestrated aneurysm clips in microvascular decompression surgery. Technical note and case series. J Neurosurg 106 : 929-931, 2007   DOI
20 Barker FG 2nd, Jannetta PJ, Bissonette DJ, Shields PT, Larkins MV, Jho HD : Microvascular decompression for hemifacial spasm. J Neurosurg 82 : 201-210, 1995   DOI
21 Campos-Benitez M, Kaufmann AM : Neurovascular compression findings in hemifacial spasm. J Neurosurg 109 : 416-420, 2008   DOI
22 Choi MS, Kim YI, Ahn YH : Lipoma causing glossopharyngeal neuralgia : a case report and review of literature. J Korean Neurosurg Soc 56 : 149-151, 2014   DOI
23 Chung SS, Chang JH, Choi JY, Chang JW, Park YG : Microvascular decompression for hemifacial spasm : a long-term follow-up of 1,169 consecutive cases. Stereotact Funct Neurosurg 77 : 190-193, 2001   DOI
24 Chung SS, Chang JW, Kim SH, Chang JH, Park YG, Kim DI : Microvascular decompression of the facial nerve for the treatment of hemifacial spasm : preoperative magnetic resonance imaging related to clinical outcomes. Acta Neurochir (Wien) 142 : 901-906; discussion 907, 2000   DOI
25 Kyoshima K, Watanabe A, Toba Y, Nitta J, Muraoka S, Kobayashi S : Anchoring method for hemifacial spasm associated with vertebral artery : technical note. Neurosurgery 45 : 1487-1491, 1999   DOI
26 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 109 : 410-415, 2008   DOI
27 Ehni G, Woltman HW : Hemifacial spasm : review of one hundred and six cases. Arch NeurPsych 53 : 205-211, 1945   DOI
28 Ferreira M, Walcott BP, Nahed BV, Sekhar LN : Vertebral artery pexy for microvascular decompression of the facial nerve in the treatment of hemifacial spasm. J Neurosurg 114 : 1800-1804, 2011   DOI
29 Kurokawa Y, Maeda Y, Toyooka T, Inaba K : Microvascular decompression for hemifacial spasm caused by the vertebral artery : a simple and effective transposition method using surgical glue. Surg Neurol 61 : 398-403, 2004   DOI
30 Kwon HM, Lee YS : Dolichoectasia of the intracranial arteries. Curr Treat Options Cardiovasc Med 13 : 261-267, 2011   DOI
31 Laws ER Jr, Kelly PJ, Sundt TM Jr : Clip-grafts in microvascular decompression of the posterior fossa. Technical note. J Neurosurg 64 : 679-681, 1986   DOI
32 Lee MH, Lee HS, Jee TK, Jo KI, Kong DS, Lee JA, et al. : Cerebellar retraction and hearing loss after microvascular decompression for hemifacial spasm. Acta Neurochir (Wien) 157 : 337-343, 2015   DOI
33 Hyun SJ, Kong DS, Park K : Microvascular decompression for treating hemifacial spasm : lessons learned from a prospective study of 1,174 operations. Neurosurg Rev 33 : 325-334, 2010   DOI
34 Khoo HM, Yoshimine T, Taki T : A "sling swing transposition" technique with pedicled dural flap for microvascular decompression in hemifacial spasm. Neurosurgery 71 (1 Suppl Operative) : 25-30; discussion 30-31, 2012   DOI
35 Ichikawa T, Agari T, Kurozumi K, Maruo T, Satoh T, Date I : "Doublestick tape" technique for transposition of an offending vessel in microvascular decompression : technical case report. Neurosurgery 68 (2 Suppl Operative) : 377-382; discussion 382, 2011
36 Illingworth RD, Porter DG, Jakubowski J : Hemifacial spasm : a prospective long-term follow up of 83 cases treated by microvascular decompression at two neurosurgical centres in the United Kingdom. J Neurol Neurosurg Psychiatry 60 : 72-77, 1996   DOI
37 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 47 : 321-328, 1977   DOI
38 Jo KW, Kong DS, Park K : Microvascular decompression for hemifacial spasm : long-term outcome and prognostic factors, with emphasis on delayed cure. Neurosurg Rev 36 : 297-301, 2013   DOI
39 Kang JH, Kang DW, Chung SS, Chang JW : The effect of microvascular decompression for hemifacial spasm caused by vertebrobasilar dolichoectasia. J Korean Neurosurg Soc 52 : 85-91, 2012   DOI
40 Kim JP, Park BJ, Choi SK, Rhee BA, Lim YJ : Microvascular decompression for hemifacial spasm associated with vertebrobasilar artery. J Korean Neurosurg Soc 44 : 131-135, 2008   DOI
41 Kondo A : Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm. Neurosurgery 40 : 46-51; discussion 51-52, 1997