USF-LVHN SELECT
Teflon versus Ivalon in Microvascular Decompression for Trigeminal Neuralgia: A 2-Center 10-Year Comparison.
Publication/Presentation Date
2-1-2021
Abstract
BACKGROUND: Trigeminal neuralgia features jolts of pain along the distribution of the trigeminal nerve. If patients fail conservative management, microvascular decompression (MVD) is typically the next step in treatment. MVD consists of implanting a separating material, often Teflon, between the nerve and compressive lesions. A review found similar success and complication rates between Teflon and Ivalon, another commonly used material. The aim of this study was to analyze outcomes and complications associated with Teflon and Ivalon in MVD.
METHODS: We conducted a 2-center retrospective cohort study of trigeminal neuralgia treated with MVD between 2005 and 2019. Patients with no postoperative follow-up were excluded. Postoperative pain was graded using the Barrow Neurological Institute (BNI) pain intensity score. Relapse was defined as a BNI score of 4-5 during follow-up after initial pain improvement or an initial BNI score of 1-3.
RESULTS: The study included 221 MVD procedures in 219 patients. Ivalon was implanted in 121 procedures, and Teflon was implanted in 100 procedures. Multivariate analysis found that implant type had no effect on final BNI score (P = 0.305). Relapse rates were similar at 5- and 10-year follow-up (5-year: Ivalon 10.7%, Teflon 18.0%, P = 0.112; 10-year: Ivalon 11.6%, Teflon 19.0%, P = 0.123). There was no difference in postoperative immediate facial numbness (P = 0.125). Postoperative hearing difficulty was higher in the Ivalon cohort (8.4% vs. 1.0%; P = 0.016).
CONCLUSIONS: We found no significant difference in final BNI score or risk of relapse between Ivalon and Teflon. Complications were similar, although Ivalon was more associated with temporary postoperative hearing loss.
Volume
146
First Page
822
Last Page
822
ISSN
1878-8769
Published In/Presented At
Pressman, E., Hasegawa, H., Farooq, J., Cohen-Cohen, S., Noureldine, M. H. A., Kumar, J. I., Chen, L., Mhaskar, R., van Loveren, H., Van Gompel, J. J., & Agazzi, S. (2021). Teflon versus Ivalon in Microvascular Decompression for Trigeminal Neuralgia: A 2-Center 10-Year Comparison. World neurosurgery, 146, e822–e828. https://doi.org/10.1016/j.wneu.2020.11.027
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
33189922
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article