J Neurol Surg B Skull Base 2020; 81(S 01): S1-S272
DOI: 10.1055/s-0040-1702679
Poster Presentations
Georg Thieme Verlag KG Stuttgart · New York

Teflon or Ivalon®: A Scoping Review of Implants Used in Microvascular Decompression for Trigeminal Neuralgia

Elliot Pressman
1   Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
R. Tushar Jha
1   Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
Gleb Zavadskiy
2   Muma College of Business, University of South Florida, Tampa, Florida, United States
,
Jay I. Kumar
1   Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
Ivo Peto
1   Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
Harry van Loveren
1   Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
Jamie J. van Gompel
3   Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States
,
Siviero Agazzi
1   Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
05 February 2020 (online)

 

Background: Trigeminal Neuralgia (TN) is characterized by jolts of pain along the distribution of the trigeminal nerve. If patients fail conservative management, microvascular decompression (MVD) is the next step in treatment. MVD is largely done by placing implant pads between the nerve and compressing vessels. We conducted a literature review to assess effectiveness and safety of Teflon and Ivalon sponges for treatment of TN with MVD.

Methods: In January 2019, PubMed was searched for manuscripts published in English using permutations of, “Microvascular decompression,” “Teflon,” “Ivalon,” “Granuloma,” “Polytetrafluoroethylene,” “Polyvinyl acetal,” “Trigeminal Neuralgia,” and “Exploration.” Success and relapse rates, causes of relapse, and complication rates were analyzed. We analyzed for relationships with ANCOVA at an α threshold of 0.05.

Results: 36 studies representing 4273 patients fit inclusion criteria. 25 dealt with initial MVD, 12 with re-do MVD. Initial MVD initial success rates were 85% in patients receiving Teflon (57–100%*), and 91% in patients receiving Ivalon (79–100%*). Recurrence rates were 12% in Teflon patients (0*–30%) and 9.1% in Ivalon patients (0*–19%). In patients with relapses, implants were the cause in 49% of Teflon patients (0*–100%*) and 50% of Ivalon patients (0*–100%*). Complication rates for patients receiving Teflon was 12% (0*–34%) and 19% for patients receiving Ivalon (0*–40%).

Conclusion: Teflon and Ivalon are two materials used in MVD for TN. It is an effective treatment with long-term symptom relief and recurrence rates of 1–5% each year. Ivalon has been used less than Teflon though is associated with similar success rates and similar complication rates.