Fleece-Bound Tissue Sealing in Microvascular Decompression

Turk Neurosurg. 2017;27(5):763-767. doi: 10.5137/1019-5149.JTN.17462-16.2.

Abstract

Aim: Cerebrospinal fluid (CSF) leakage is a feared complication after microvascular decompression (MVD). In this study, we present our experience of fleece-bound tissue sealing in MVD with an aim to minimize the rate of postoperative CSF leakage.

Material and methods: We treated 50 patients (female/male: 26/24) with neurovascular compression (NVC) syndromes (trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia) by MVD from 2003 to 2006. All patients underwent retromastoid craniectomy and duraplasty by fleece-bound tissue sealing using the so-called "sandwich technique" by a three-layer reconstruction and cranioplasty.

Results: In 49 (98%) of 50 patients, we did not observe postoperative CSF leakage. One patient (2%) suffered postoperative CSF leakage and required surgical revision.

Conclusion: Fleece-bound tissue sealing by a three-layer reconstruction is effective and safe in the prevention of cerebrospinal fluid leakage in microvascular decompression.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebrospinal Fluid Leak / etiology
  • Cerebrospinal Fluid Leak / surgery
  • Craniotomy / adverse effects
  • Craniotomy / methods*
  • Female
  • Glossopharyngeal Nerve Diseases / surgery*
  • Hemifacial Spasm / surgery*
  • Humans
  • Male
  • Microvascular Decompression Surgery / adverse effects
  • Microvascular Decompression Surgery / methods*
  • Middle Aged
  • Postoperative Complications / surgery
  • Reoperation
  • Skull / surgery
  • Treatment Outcome
  • Trigeminal Neuralgia / surgery*
  • Young Adult