A comparison of long-term outcomes between interposition with Teflon and autologous muscle in microvascular decompression for trigeminal neuralgia

Objective : Microvascular decompression (MVD) is an established surgical procedure for treating classical trigeminal neuralgia (TN) by separating the trigeminal nerve from an offending vessel. Various materials can be used for interposition, Teflon being the standard in many centers. Autologous muscle is used as an alternative; however, comparative studies are sparse. We compared the outcomes of patients who underwent MVD for TN with either Teflon or muscle in the same center. Methods : We searched our database for patients who underwent MVD for TN between 2007 and 2024. The records were analyzed for outcome parameters, and patients or their relatives were contacted via phone if follow-up data were insufficient. Exclusion criteria included repeat MVD, lack of initial improvement after surgery, and loss to follow-up. The primary outcome parameter was treatment failure, defined as Barrow Neurological Institute (BNI) pain intensity score IV or V. Results : 70 patients were identified. After applying the exclusion criteria, 48 were available for the outcome analysis, among whom 21 had received interposition with muscle and 27 with Teflon. The mean patient age was 65 years, 56.25% were female, and the pain was right-sided in 62.5% of patients. At a mean follow-up of 85 months, 12.5% had experienced treatment failure (14.29% in the muscle group and 11.11% in the Teflon group; p = 0.741). Kaplan-Meier analysis with log-rank test and logistic regression analysis revealed no significant differences. Conclusions : We found no differences in the outcomes of MVD for TN when either autologous muscle or Teflon was used. Both materials are appropriate for interposition.