Prosthesis Used in Microvascular Decompressions: A Multicenter Survey in Japan Focusing on Adverse Events

Mitsuhiro Hasegawa, Toru Hatayama, Akinori Kondo, Shinji Nagahiro, Takamitsu Fujimaki, Kenichi Amagasaki, Kazunori Arita, Isao Date, Yukihiko Fujii, Takeo Goto, Ryosuke Hanaya, Yoshinori Higuchi, Kazuhiro Hongo, Toru Inoue, Hidetoshi Kasuya, Takamasa Kayama, Masatou Kawashima, Eiji Kohmura, Taketoshi Maehara, Toshio MatsushimaYoshihumi Mizobuchi, Akio Morita, Shigeru Nishizawa, Shusaku Noro, Shinjiro Saito, Hirofumi Shimano, Reizo Shirane, Hideo Takeshima, Yuichiro Tanaka, Hidenori Tanabe, Hiroki Toda, Iwao Yamakami, Yuya Nishiyama, Shigeo Ohba, Yuichi Hirose, Takeya Suzuki

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the characteristics of materials used as prostheses for microvascular decompression surgery (MVDs) in Japan and their possible adverse events (AEs) to determine preferable materials for MVDs. Methods: A questionnaire was sent to all members of the Japanese Society for MVDs, and answers were obtained from 59 institutions. Results: Among a total of 2789 MVDs, 1088 operations for trigeminal neuralgia, 1670 for hemifacial spasm, and 31 others, including 117 reoperations, were performed between April 2011 and March 2014. Nonabsorbable material was used in 96.5% of MVDs, including polytetrafluoroethylene (PTFE) (80.5%), polyurethane (11.9%), expanded PTFE (2.1%), and silk thread (1.47%). The use of absorbable materials, including fibrin glue (87.5%), cellulose (13.5%), gelatin (4,77%), and collagen (1.76%), was reported. The major combinations were PTFE with fibrin glue (58.7%) followed by PTFE alone (7.60%). Eighty-eight AEs in 85 (3.2%) cases were reported among 2672 first operations. AEs included 51 central nervous system dysfunctions, 15 wound infections/dehiscence, and 10 others, which were presumed to be related to the intraoperative procedure. Among relatively high-, moderate-, and low-volume centers, there were no significant differences in the frequency of AEs (P = 0.077). Tissue-prosthesis adhesion and/or granuloma formation were reported in 13 cases of 117 reoperations. The incidence of adhesion-related recurrence was 11.1% of all reoperations. Conclusions: The number of AEs was quite low in this survey, and intradural use of any prosthesis reported in this paper might be justified; however, further development of easily handled and less-adhesive prosthesis materials is awaited.

Original languageEnglish
Pages (from-to)e251-e258
JournalWorld Neurosurgery
Volume130
DOIs
Publication statusPublished - Oct 2019

Keywords

  • Absorbable material
  • Adverse event
  • Microvascular decompression
  • Non-absorbable material
  • Prosthesis
  • Surgical technique

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Hasegawa, M., Hatayama, T., Kondo, A., Nagahiro, S., Fujimaki, T., Amagasaki, K., Arita, K., Date, I., Fujii, Y., Goto, T., Hanaya, R., Higuchi, Y., Hongo, K., Inoue, T., Kasuya, H., Kayama, T., Kawashima, M., Kohmura, E., Maehara, T., ... Suzuki, T. (2019). Prosthesis Used in Microvascular Decompressions: A Multicenter Survey in Japan Focusing on Adverse Events. World Neurosurgery, 130, e251-e258. https://doi.org/10.1016/j.wneu.2019.06.053