Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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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)
  • Received : 2016.04.08
  • Accepted : 2016.07.20
  • Published : 2016.09.01
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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

References

  1. Attabib N, Kaufmann AM : Use of fenestrated aneurysm clips in microvascular decompression surgery. Technical note and case series. J Neurosurg 106 : 929-931, 2007 https://doi.org/10.3171/jns.2007.106.5.929
  2. Barker FG 2nd, Jannetta PJ, Bissonette DJ, Shields PT, Larkins MV, Jho HD : Microvascular decompression for hemifacial spasm. J Neurosurg 82 : 201-210, 1995 https://doi.org/10.3171/jns.1995.82.2.0201
  3. Bejjani GK, Sekhar LN : Repositioning of the vertebral artery as treatment for neurovascular compression syndromes. Technical note. J Neurosurg 86 : 728-732, 1997 https://doi.org/10.3171/jns.1997.86.4.0728
  4. Campos-Benitez M, Kaufmann AM : Neurovascular compression findings in hemifacial spasm. J Neurosurg 109 : 416-420, 2008 https://doi.org/10.3171/JNS/2008/109/9/0416
  5. 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 https://doi.org/10.3340/jkns.2014.56.2.149
  6. 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 https://doi.org/10.1159/000064620
  7. 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 https://doi.org/10.1007/s007010070076
  8. 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 https://doi.org/10.3171/JNS/2008/109/9/0410
  9. Ehni G, Woltman HW : Hemifacial spasm : review of one hundred and six cases. Arch NeurPsych 53 : 205-211, 1945 https://doi.org/10.1001/archneurpsyc.1945.02300030042006
  10. 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 https://doi.org/10.3171/2010.12.JNS10891
  11. 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 https://doi.org/10.1016/j.surneu.2007.07.027
  12. 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 https://doi.org/10.1007/s10143-010-0254-9
  13. 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
  14. 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 https://doi.org/10.1136/jnnp.60.1.72
  15. 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 https://doi.org/10.3171/jns.1977.47.3.0321
  16. 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 https://doi.org/10.1007/s10143-012-0420-3
  17. 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 https://doi.org/10.3340/jkns.2012.52.2.85
  18. 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 https://doi.org/10.1227/01.neu.0000417538.53612.f8
  19. 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 https://doi.org/10.3340/jkns.2008.44.3.131
  20. Kondo A : Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm. Neurosurgery 40 : 46-51; discussion 51-52, 1997
  21. 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 https://doi.org/10.1016/S0090-3019(03)00425-7
  22. Kwon HM, Lee YS : Dolichoectasia of the intracranial arteries. Curr Treat Options Cardiovasc Med 13 : 261-267, 2011 https://doi.org/10.1007/s11936-011-0123-z
  23. 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 https://doi.org/10.1097/00006123-199912000-00048
  24. 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 https://doi.org/10.3171/jns.1986.64.4.0679
  25. 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 https://doi.org/10.1007/s00701-014-2301-8
  26. 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
  27. 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 https://doi.org/10.1007/s10143-011-0310-0
  28. 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 https://doi.org/10.3171/jns.1999.90.1.0001
  29. 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
  30. 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 https://doi.org/10.1007/s00701-007-1457-x
  31. Park KD, Kim YI, Ahn YH : Cerebello-pontine angle lipoma causing hemifacial spasm. J Korean Soc Ster Func Neurosurg 10 : 37-40, 2014
  32. Payner TD, Tew JM Jr : Recurrence of hemifacial spasm after microvascular decompression. Neurosurgery 38 : 686-690; discussion 690-691, 1996 https://doi.org/10.1227/00006123-199604000-00009
  33. Rawlinson JN, Coakham HB : The treatment of hemifacial spasm by sling retraction. Br J Neurosurg 2 : 173-178, 1988 https://doi.org/10.3109/02688698808992667
  34. 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 https://doi.org/10.1097/00006123-200204000-00005
  35. 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 https://doi.org/10.2176/nmc.42.184
  36. 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
  37. 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
  38. 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 https://doi.org/10.3171/2014.12.JNS141699
  39. 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
  40. 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
  41. 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 https://doi.org/10.1016/j.jocn.2014.09.008

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