Department of Neurosurgery, Tokyo General Hospital, Tokyo , Japan.
Department of Neurosurgery, National Defense Medical College, Tokorozawa , Saitama , Japan.
Oper Neurosurg (Hagerstown). 2023 Nov 1;25(5):417-425. doi: 10.1227/ons.0000000000000844. Epub 2023 Sep 1.
Use of TachoSil ® as the transposition material of microvascular decompression (MVD) for hemifacial spasm (HFS) and trigeminal neuralgia (TN) is easy and safe to perform, but the efficacy and safety of this technique are unknown. This study attempted to validate the efficacy and safety of TachoSil ® as a transposition material of MVD.
A retrospective study of the surgical results and complications of 63 patients (35 HFS and 28 TN) treated by the TachoSil ® technique between January 2011 and December 2021 was conducted. The efficacy of the treatment was evaluated by Kaplan-Meier survival analysis. Magnetic resonance imaging follow-up study was performed to detect any adverse events including a mass formation.
The rate of complete disappearance of HFS was 91.4% at 1 year and estimated to be 85.7% after a 10-year follow-up. The rate of no pain without medication for TN was 85.4% at 1 year and estimated to be 69.0% after a 9-year follow-up. These surgical results are comparable with those previously reported. Flaking of TachoSil ® releasing the offending artery was only recognized in one case (1.6%). Therefore, TachoSil ® can be considered as an effective transposition material for MVD. TachoSil ® did not increase the rate of acute and subacute adverse events such as inflammation and delayed facial palsy. Magnetic resonance imaging follow-up identified no abnormalities including mass that suggested granuloma formation.
The efficacy of the TachoSil ® technique for HFS and TN and the reliability of TachoSil ® as an adhesive material in MVD were verified. No adverse events associated with TachoSil ® use in MVD were found. We conclude that the TachoSil ® technique has relatively long efficacy and safety for MVD.
使用 TachoSil ® 作为微血管减压术（MVD）的转位材料治疗面肌痉挛（HFS）和三叉神经痛（TN）既简单又安全，但该技术的疗效和安全性尚不清楚。本研究试图验证 TachoSil ® 作为 MVD 转位材料的疗效和安全性。
对 2011 年 1 月至 2021 年 12 月期间采用 TachoSil ® 技术治疗的 63 例患者（35 例 HFS 和 28 例 TN）的手术结果和并发症进行回顾性研究。采用 Kaplan-Meier 生存分析评估治疗效果。磁共振成像（MRI）随访检查以检测包括肿块形成在内的任何不良事件。
HFS 完全消失的比例为 1 年时的 91.4%，10 年随访时估计为 85.7%。TN 无疼痛且无需药物治疗的比例为 1 年时的 85.4%，9 年随访时估计为 69.0%。这些手术结果与以往报道的结果相当。仅在 1 例（1.6%）中发现 TachoSil ® 片状脱落释放出致病动脉。因此，TachoSil ® 可被视为 MVD 的一种有效转位材料。TachoSil ® 并未增加炎症和迟发性面瘫等急性和亚急性不良事件的发生率。MRI 随访未发现包括肉芽肿形成的异常。
TachoSil ® 技术治疗 HFS 和 TN 的疗效以及 TachoSil ® 作为 MVD 黏附材料的可靠性得到了验证。在 MVD 中使用 TachoSil ® 未发现与该材料相关的不良事件。我们的结论是，TachoSil ® 技术在 MVD 中具有相对较长的疗效和安全性。
