Improved Microvascular Decompression in Treating Trigeminal Neuralgia: Application of Nest-Shaped Teflon Fibers.

OBJECTIVE: To develop an improved technique for microvascular decompression (MVD) surgery using nest-shaped Teflon fibers. METHODS: Eighteen consecutive patients with trigeminal neuralgia (TN) who underwent MVD using nest-shaped Teflon fibers between January 2012 and December 2013 were included in this investigation. During the surgery, the Teflon prosthesis was formed into a nest shape by gently pushing it from the center toward the periphery. Immediate postoperative outcomes were evaluated using a numerical rating scale score, and patients were followed up for recurrence. RESULTS: Immediately after the surgery, pain was completely relieved in 16 patients (88.9%) and partially relieved in 2 patients (11.1%). Seven patients (38.9%) developed postoperative complications. All complications were successfully mitigated before discharge. The patients were followed up for 2.0-3.4 years. During follow-up, recurrence was observed in 2 patients (11.1%). No Teflon adhesion or Teflon-induced granuloma was found. CONCLUSIONS: The nest-shaped Teflon fibers in MVD surgery for TN is safe and applicable. The long-term outcomes and the comparison between hollow nest-shaped implants and the standard cigar-shaped implants should be assessed in future investigations with larger sample sizes.