Bovine pericardial patch in an eggroll fashion and teflon felt microvascular decompression for trigeminal neuralgia and hemifacial spasm: A retrospective study

Teflon felt (TFF) is widely adopted for microvascular decompression surgeries (MVDS) for hyperactivity syndrome involving the trigeminal neuralgia (TGN) and hemifacial spasm (HFS) while bovine pericardial patch (BPP) used for dural graft and not MVDS. We speculated that BPP roll around the nerve like an eggroll and fixed with a closing suture may solve the complications associated with TFF dependent MVDS and reduce hospital cost. We conducted a comparative retrospective study on all MVDS for TGN and HFS performed at the department of Neurosurgery, West China Hospital from January 1, 2015, to January 1, 2022. Data like clinical and imaging characteristics, operative procedures, postoperative complications, recurrence rate were recorded and compared between patients who underwent TFF and BPP MVDS. We observed a significant statistical difference (P = .0135) in recurrence and granuloma formation between the TFF and BPP MVDS. The time of recurrence and the annual rate of control of symptomatology were almost same in both groups until 30 months onwards where cases of recurrences were high in the TFF MVDS (4.2% vs 0%; P = .0135, 95% CI: 1.8-6.5%). Also, total cost was relatively lower in BPP MVDS compare to the TFF MVDS (P = .00135). BPP roll around the nerve like an eggroll and fixed with a closing suture could be a good alternative for TFF dependent MVDS. Notably, the BPP MVDS had no granuloma formation and no recurrence of symptomatology.