![]() ![]() ![]() Our purpose was to research the factors that may induce Teflon granuloma in trigeminal neuralgia patients who have undergone microvascular decompression (MVD) procedures, to propose methods for the early diagnosis of Teflon granuloma, and provide suggestions for reducing this complication.įrom 1985 to 1996, 89 trigeminal neuralgia patients underwent MVD with Teflon felt to separate the offending vessels and the trigeminal nerve. A feasible treatment option is surgical re-exploration, nerve preserving removal of the granuloma, and repeat MVD. Small bleeding into the Teflon felt at surgery might trigger its development. Teflon granuloma is a rare cause for recurrent facial pain after MVD. Patients were free of pain after the second procedure at a mean of 40.3 months of follow-up. The Teflon granuloma was completely removed, and a new Teflon felt was used for re-decompression. Histopathological examination revealed foreign body granuloma with multinuclear giant cells, collagen-rich hyalinized scar tissue, focal hemosiderin depositions, and microcalcifications. ![]() Intraoperatively dense fibrous tissue was found at the site of the Teflon granuloma. MRI scans demonstrated local gadolineum enhancement in the cerebellopontine angle, and CT scans showed local calcification. Recurrence of pain occurred between 1 and 8.5 years after the first procedure. Mean age at the first procedure was 62.3 years and at the second procedure 66.3 years. In each instance, the granuloma was removed for histopathological examination. In three patients with recurrent facial pain Teflon granuloma was found to be the cause for recurrence. In a series of 200 patients with trigeminal neuralgia MVD was performed with Teflon felt according to Jannetta's technique. Here, we report on our experience with Teflon granuloma including its treatment and histopathological examination. Recurrent trigeminal neuralgia after microvascular decompression (MVD) may be due to insufficient decompression, dislocation of the implant to pad the neurovascular contact, or the development of granuloma. ![]()
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