{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T18:53:00Z","timestamp":1768071180042,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T00:00:00Z","timestamp":1567209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Microvascular decompression (MVD) may be employed in the management of hemifacial spasm (HFS), wherein a pledget of polytetrafluoroethylene (i.e., Teflon, Chemours, Wilmington DE) is sometimes introduced to separate an offending vessel from the cisternal segment of facial nerve. Rarely, Teflon may cause a granulomatous reaction resulting in nerve palsy. We here present the first case series of facial palsy thought to be secondary to Teflon granuloma following MVD for HFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A data repository of 1,312 patients with facial palsy was reviewed to identify individuals who had previously undergone MVD for HFS. Data collected include age at time of MVD, age at onset of facial weakness and at presentation, House\u2010Brackmann scores, clinician\u2010graded facial function using the Electronic Facial Paralysis Assessment scale, imaging findings, and therapeutic interventions and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six patients meeting criteria were identified. Average time between MVD with Teflon placement and onset of facial weakness was 16.1 (\u00b14.9) years (range 9.3\u201323.3\u2009years). Initial House\u2010Brackmann scores were as follows: four patients with V\/VI and one each with III\/VI and IV\/VI. Interventions included eyelid weight placement (n = 3), chemodenervation (n = 2), static suspension with tensor fascia latae (n = 2), dynamic reanimation with cranial nerves V to VII transfer (n = 1), and temporalis muscle transfer (n = 1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Teflon granuloma should be considered in the differential diagnosis for patients presenting with new onset facial weakness with a previous history of MVD for HFS. It remains unknown whether early granuloma extirpation is effective. Prompt diagnosis allows consideration of time\u2010sensitive nerve transfer procedures to reanimate facial function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:bold><jats:italic>Laryngoscope, 130:1422\u20131427, 2020<\/jats:italic><\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28257","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T10:49:09Z","timestamp":1567248549000},"page":"1422-1427","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Polytetrafluoroethylene granuloma\u2010associated facial palsy following microvascular decompression"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4324-8113","authenticated-orcid":false,"given":"Adeeb","family":"Derakhshan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline J.","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts U.S.A."},{"name":"Division of Otolaryngology University of California San Diego  La Jolla California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3274-4488","authenticated-orcid":false,"given":"Shekhar K.","family":"Gadkaree","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2992-4771","authenticated-orcid":false,"given":"Jenny X.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nate","family":"Jowett","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa A.","family":"Hadlock","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2015.06.032"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.59.3.418"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/JNS\/2008\/109\/9\/0410"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1968.00760060639017"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1962.00740050080015"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02273864"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00346368"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(93)90286-D"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1975.00780310036010"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949510400702"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(10)80300-3"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3171\/JNS\/2008\/108\/5\/0916"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199410000-00012"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1997.87.3.0454"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(00)00169-5"},{"key":"e_1_2_6_17_1","first-page":"783","article-title":"Teflon granuloma presenting as an enlarging, gadolinium enhancing, posterior fossa mass with progressive hearing loss following microvascular decompression","volume":"16","author":"Megerian CA","year":"1995","journal-title":"Am J Otol"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-017-0865-5"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26126"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000001447"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002340050366"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880080702"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870090310"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1984.61.3.0569"},{"key":"e_1_2_6_25_1","first-page":"667","article-title":"Hemifacial spasm: conservative and surgical treatment options","volume":"109","author":"Rosenstengel C","year":"2012","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199812)21:12<1740::AID-MUS17>3.0.CO;2-V"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1977.47.3.0321"},{"key":"e_1_2_6_28_1","first-page":"933","article-title":"Findings and long\u2010term results of subsequent operations after failed microvascular decompression for trigeminal neuralgia","volume":"39","author":"Rath SA","year":"1996","journal-title":"Neurosurgery"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.4103\/1793-5482.103713"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.30.462"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(88)90740-6"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199904040-00029"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10194-010-0213-4"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-011-1168-1"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1999.90.1.0001"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.28257","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28257","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.28257","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28257","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T07:29:54Z","timestamp":1693985394000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.28257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,31]]},"references-count":34,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1002\/lary.28257"],"URL":"https:\/\/doi.org\/10.1002\/lary.28257","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,31]]},"assertion":[{"value":"2019-07-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}