• World Neurosurg · Feb 2021

    Comparative Study

    Teflon™ versus Ivalon® in Microvascular Decompression for Trigeminal Neuralgia: A Two-Center Ten-Year Comparison.

    • Elliot Pressman, Hirotaka Hasegawa, Jeffrey Farooq, Salomon Cohen-Cohen, Mohammad Hassan A Noureldine, Jay I Kumar, Liwei Chen, Rahul Mhaskar, Harry van Loveren, Jamie J Van Gompel, and Siviero Agazzi.
    • Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, USA.
    • World Neurosurg. 2021 Feb 1; 146: e822-e828.

    BackgroundTrigeminal 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.MethodsWe 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.ResultsThe 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).ConclusionsWe 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.Copyright © 2020 Elsevier Inc. All rights reserved.

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