Teflon bridge technique for endoscopic-assisted microvascular decompression of ectatic basilar artery and anterior inferior cerebellar artery for trigeminal neuralgia: operative video and technical nuances

James K Liu; Asif Shafiq

doi:10.3171/2020.7.FOCVID2032

Teflon bridge technique for endoscopic-assisted microvascular decompression of ectatic basilar artery and anterior inferior cerebellar artery for trigeminal neuralgia: operative video and technical nuances

Neurosurg Focus Video. 2020 Oct 1;3(2):V5. doi: 10.3171/2020.7.FOCVID2032. eCollection 2020 Oct.

Authors

James K Liu^{1

2

3}, Asif Shafiq¹

Affiliations

¹ Departments of Neurological Surgery and.
² Otolaryngology-Head and Neck Surgery.
³ Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, Newark; Saint Barnabas Medical Center, RWJ Barnabas Health, Livingston, New Jersey.

Abstract

In this illustrative operative video, the authors demonstrate a Teflon bridge technique to achieve safe transposition of a large, tortuous ectatic basilar artery (BA) and anterior inferior cerebellar artery (AICA) complex to decompress the root entry zone (REZ) of the trigeminal nerve in a 61-year-old woman with refractory trigeminal neuralgia via an endoscopic-assisted retractorless microvascular decompression. Postoperatively, the patient experienced immediate facial pain relief without requiring further medications. The Teflon bridge technique can be a safe alternative to sling techniques when working in narrow surgical corridors between delicate nerves and vessels. The operative technique and surgical nuances are demonstrated. The video can be found here: https://youtu.be/hIHX7EvZc1c.

Keywords: ectatic basilar artery; endoscopic-assisted; microvascular decompression; operative video; trigeminal neuralgia.