Kato Koichi, Ujiie Hiroshi, Nakano Hiroshi, Nomura Shunsuke, Nakagawa Masanori, Higa Takashi, Kadoyama Shigeru, Teramoto Akira
Department of Neurosurgery, Tokyo Rosai Hospital.
Neurol Med Chir (Tokyo). 2017 Nov 15;57(11):601-606. doi: 10.2176/nmc.oa.2017-0007. Epub 2017 Sep 26.
Accurate and long-term transposition of offending vessels is required in microvascular decompression (MVD) for the treatment of hemifacial spasm (HFS) and trigeminal neuralgia (TN). We created ion-beam implanted of an expanded-polytetrafluoroethylene (i-ePTFE) surface to transpose offending vessels in MVD. In 13 patients with MVD, we concealed and transposed offending vessels with tape-shaped i-ePTFE, and relieved facial and trigeminal nerve compression by attaching the i-ePTFE to the dura with fibrin glue. After surgery, none of the patients reported further symptoms or experienced recurrence of symptoms up to 12 months post-surgery. Favorable surgical outcomes are obtainable, since i-ePTFE has high tissue affinity and is easy to manipulate, even under a narrow and deep operative field. Our results suggested that i-ePTFE is very useful for transposition in MVD.
在微血管减压术(MVD)治疗面肌痉挛(HFS)和三叉神经痛(TN)中,需要准确且长期地移位肇事血管。我们制作了离子束植入的膨体聚四氟乙烯(i - ePTFE)表面,用于在MVD中移位肇事血管。在13例接受MVD的患者中,我们用带状i - ePTFE隐蔽并移位肇事血管,并用纤维蛋白胶将i - ePTFE附着于硬脑膜以解除对面神经和三叉神经的压迫。术后,直至术后12个月,无一例患者报告有进一步症状或症状复发。由于i - ePTFE具有高组织亲和力且易于操作,即使在狭窄和深部手术视野下也是如此,因此可获得良好的手术效果。我们的结果表明,i - ePTFE在MVD的移位术中非常有用。