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Teflon™ or Ivalon®: a scoping review of implants used in microvascular decompression for trigeminal neuralgia

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Abstract

Background

Trigeminal neuralgia (TN) is characterized by jolts of pain along the distribution of the trigeminal nerve. If patients fail conservative management, microvascular decompression (MVD) is the next step in treatment. MVD is largely done by placing implant pads between the nerve and compressing vessels. We conducted a literature review to assess effectiveness and safety of Teflon™ and Ivalon® sponges for treatment of TN with MVD.

Methods

In January 2019, PubMed was searched for manuscripts published in English using permutations of “Microvascular decompression”, “Teflon”, “Ivalon”, “Granuloma”, “Polytetrafluoroethylene”, “Trigeminal Neuralgia”, and “Exploration”. Success and relapse rates, causes of relapse, and complication rates were analyzed. We analyzed for relationships with ANCOVA at an alpha threshold of .05.

Results

Thirty-six studies representing 4273 patients fit inclusion criteria. Twenty-five dealt with initial MVD, 12 with re-do MVD. Initial MVD initial success rates were 85% in patients receiving Teflon™ (57–100%*) and 91% in patients receiving Ivalon® (79–100%*). Recurrence rates were 12% in Teflon™ patients (0*–30%) and 9.1% in Ivalon® patients (0*–19%). In patients with relapses, implants were the cause in 49% of Teflon™ patients (0*–100%*) and 50% of Ivalon® patients (0*–100%*). Complication rates for patients receiving Teflon™ were 12% (0*–34%) and 19% for patients receiving Ivalon® (0*–40%).

Conclusion

Teflon™ and Ivalon® are two materials used in MVD for TN. It is an effective treatment with long-term symptom relief and recurrence rates of 1–5% each year. Ivalon® has been used less than Teflon™ though is associated with similar success rates and similar complication rates.

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Funding

Our scoping review received no financial support for the research, authorship, and/or publication of this article. In addition, of the sources of evidence included in this article, the ones that disclosed a source of funding and the funding received are as follows: Feng et al. (2015) were supported by a grant from the National Science Foundation of China, a grant from the Health Commission of Shanghai, and 2 grants from the Science and Technology Commission of Shanghai.[16] Wu et al. were supported by a grant from the Science and Technology Project of Anhui Province, China.[37] Feng et al. (2018) were supported by a grant from Shanghai Jiao Tong University cross fund for medical engineering.[15]

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Authors and Affiliations

  1. Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, 33606, USA

    Elliot Pressman, R. Tushar Jha, Jay I. Kumar, Harry van Loveren & Siviero Agazzi

  2. Muma College of Business, University of South Florida, Tampa, FL, USA

    Gleb Zavadskiy

  3. Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA

    Jamie J. van Gompel

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  1. Elliot Pressman
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Correspondence to Siviero Agazzi.

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Pressman, E., Jha, R.T., Zavadskiy, G. et al. Teflon™ or Ivalon®: a scoping review of implants used in microvascular decompression for trigeminal neuralgia. Neurosurg Rev 43, 79–86 (2020). https://doi.org/10.1007/s10143-019-01187-0

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