Download PDF
Skull Base 2007; 17(4): 247-252
DOI: 10.1055/s-2007-984492
CASE REPORT

Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Teflon Granuloma of the Skull Base: A Complication of Endonasal Brain Surgery

Ryan J. Soose1 , Carl H. Snyderman1 , Amin B. Kassam2
  • 1Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
  • 2Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Further Information

Publication History

Publication Date:
13 July 2007 (online)

    Permissions and Reprints

See also:

Commentary “Teflon Granuloma of the Skull Base: A Complication of Endonasal Brain Surgery”Skull Base 2007; 17(04): 252-252
DOI: 10.1055/s-2007-984493

ABSTRACT

Teflon granuloma is an inflammatory giant-cell foreign-body reaction to polytetrafluoroethylene fibers or injection. Tissue augmentation with Teflon has dramatically declined over the past two decades because of its implication in granuloma formation. Nevertheless, Teflon felt is still commonly used in neurosurgical dissection and microvascular decompression. We report a patient with a Teflon granuloma of the skull base discovered 1.5 years after endonasal resection of an olfactory groove meningioma. The case highlights the clinical and radiographic diagnosis as well as the management of this unusual finding.

KEYWORDS

Teflon granuloma - endonasal neurosurgery - meningioma - skull base

REFERENCES

  • 1 Varvares M A, Montgomery W W, Hillman R E. Teflon granuloma of the larynx: etiology, pathophysiology, and management.  Ann Otol Rhinol Laryngol. 1995;  104 511-515
    PubMedGoogle Scholar
  • 2 Harrigal C, Branstetter B F, Snyderman C H et al.. Teflon granuloma in the nasopharynx: a potentially false-positive PET/CT finding.  AJNR Am J Neuroradiol. 2005;  26 417-420
    PubMedGoogle Scholar
  • 3 Hewitt R J, Singh A, Wareing M J. Teflon-induced granuloma: a source of false positive positron emission tomography and computerized tomography interpretation.  J Laryngol Otol. 2004;  118 822-824
    PubMedGoogle Scholar
  • 4 Yeretsian R A, Blodgett T M, Branstetter B F et al.. Teflon-induced granuloma: a false-positive finding with PET resolved with combined PET and CT.  AJNR Am J Neuroradiol. 2003;  24 1164-1166
    PubMedGoogle Scholar
  • 5 Wasserman B N, Sprunger D T, Helveston E M. Comparison of materials used in frontalis suspension.  Arch Ophthalmol. 2001;  119 687-691
    CrossrefPubMedGoogle Scholar
  • 6 Smith R M, Goldwasser M S, Sabol S R. Erosion of a Teflon-Proplast implant into the middle cranial fossa.  J Oral Maxillofac Surg. 1993;  51 1268-1271
    PubMedGoogle Scholar
  • 7 Chen J, Shih-Tseng L, Lui T et al.. Teflon granuloma after microvascular decompression for trigeminal neuralgia.  Surg Neurol. 2000;  53 281-287
    CrossrefPubMedGoogle Scholar
  • 8 Ozeren M, Han U, Mavioglu I et al.. Consequences of PTFE membrane used for prevention of re-entry injuries in rheumatic valve disease.  Cardiovasc Surg. 2002;  10 489-493
    PubMedGoogle Scholar
  • 9 Kassam A, Snyderman C H, Mintz A et al.. Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica.  Neurosurg Focus. 2005;  19 1-12
    PubMedGoogle Scholar
  • 10 Dedo H J. Injection and removal of Teflon for unilateral vocal cord paralysis.  Ann Otol Rhinol Laryngol. 1992;  101 81-86
    PubMedGoogle Scholar
  • 11 Rubin H J. Misadventures with injectable polytef (Teflon).  Arch Otolaryngol. 1975;  101 114-116
    PubMedGoogle Scholar
  • 12 Nakayama M, Ford C N, Bless D M. Teflon vocal fold augmentation: failures and management in 28 cases.  Otolaryngol Head Neck Surg. 1993;  109 493-498
    PubMedGoogle Scholar
  • 13 Kirchner F R, Toledo P, Svoboda D. Studies of the larynx after Teflon injection.  Arch Otolaryngol. 1966;  83 350-354
    PubMedGoogle Scholar
  • 14 Toomey J M, Brown B S. The histological response to intracordal injection of Teflon paste.  Laryngoscope. 1967;  77 110-120
    CrossrefPubMedGoogle Scholar
  • 15 Dedo H H, Carlsoo B. Histologic evaluation of Teflon granulomas of human vocal cords. A light and electron microscopic study.  Acta Otolaryngol. 1982;  93 475-484
    PubMedGoogle Scholar
  • 16 Megerian C A, Busaba N Y, McKenna M J et al.. Teflon granuloma presenting as an enlarging, gadolinium enhancing, posterior fossa mass with progressive bilateral hearing loss following microvascular decompression.  Am J Otol. 1995;  16 783-786
    PubMedGoogle Scholar
  • 17 Premsagar I C, Moss T, Coakham H B. Teflon-induced granuloma following treatment of trigeminal neuralgia by microvascular decompression. Report of two cases.  J Neurosurg. 1997;  87 454-457
    CrossrefPubMedGoogle Scholar
  • 18 Loehrl T A, Smith T L. Inflammatory and granulomatous lesions of the larynx and pharynx.  Am J Med. 2001;  111 113S-117S
    CrossrefPubMedGoogle Scholar

Carl H SnydermanM.D. 

Department of Otolaryngology, University of Pittsburgh Medical Center

203 Lothrop St., Ste. 500, Pittsburgh, PA 15213

Email: snydermanch@upmc.edu

      >