title: Bioglue-Coated Teflon Sling Technique in Microvascular Decompression for Hemifacial Spasm Involving the Vertebral Artery.
abstract: OBJECTIVE
  Microvascular decompression (MVD) for hemifacial spasm (HFS) involving the vertebral artery (VA) can be technically challenging. We investigated the therapeutic effects of a bioglue-coated Teflon sling technique on the VA during MVD in 42 cases.
  
  
  METHODS
  A bioglue-coated Teflon sling was crafted by the surgeon and applied to patients in whom neurovascular compression was caused by the VA. The radiologic data, intra-operative findings with detailed introduction of the procedure, and the clinical outcomes of each patient were reviewed and analyzed.
  
  
  RESULTS
  The 42 patients included in the analysis consisted of 22 females and 20 males, with an average follow-up duration of 76 months (range 24-132 months). Intraoperative investigation revealed that an artery other than the VA was responsible for the neurovascular compression in all cases : posterior inferior cerebellar artery (PICA) in 23 patients (54.7%) and anterior inferior cerebellar artery (AICA) in 11 patients (26.2%). All patients became symptom-free after MVD. Neither recurrence nor postoperative neurological deficit was noted during the 2-year follow-up, except in one patient who developed permanent deafness. Cerebrospinal fluid (CSF) leak occurred in three patients, and one required dural repair.
  
  
  CONCLUSIONS
  Transposition of the VA using a bioglue-coated Teflon sling is a safe and effective surgical technique for HFS involving the VA. A future prospective study to compare clinical outcomes between groups with and without use of this novel technique is required.
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea.
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.; Neuroscience Graduate Program, Department of Biomedical Sciences, Graduate School of Ajou University, Suwon, Korea.
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Ahn
keywords: Bioglue; Hemifacial spasm; Microvascular decompression; Sling; Teflon; Vertebral artery