Microvascular decompression surgery (MVD) is a procedure used to treat intensely painful or spasming facial nerves in patients for whom medications haven't worked.
In microvascular decompression surgery, one or more Teflon sponges are placed in between a person’s trigeminal nerve and a blood vessel. This helps protect the trigeminal nerve from the heat and pressure caused by the blood vessel that is leaning on or compressing the trigeminal nerve, causing pain. The placement of the sponge acts as a cushion which helps calm the overactive nerve.
- Most patients spend about two days in the hospital following microvascular decompression surgery. The recovery time for microvascular decompression surgery takes between two to four weeks.
- Many patients notice immediate pain relief following the procedure and it takes about a week for pain and stiffness to resolve. It may take a few weeks before symptoms completely go away.
- Patients can shower and wash their hair 72 hours after the procedure and can perform normal activities at home, but should not drive or lift anything heavy. Most patients can start to drive about one week after surgery.
- Patients should avoid physical exertion, including heavy lifting, for six weeks.
Who Gets Microvascular Decompression Surgery?
3 uses for microvascular decompression surgery
Microvascular decompression surgery is indicated for patients with the following conditions who have not responded to medication:
- Trigeminal neuralgia
- The trigeminal nerve is the major sensory nerve of the face
- It is a nerve disorder caused by compression of the trigeminal nerve by an artery or vein that causes episodes of severe stabbing or electric shock-like pain in parts of the face
- Glossopharyngeal neuralgia
- Affects the glossopharyngeal nerve deep within the neck
- It is a nerve disorder often caused by a blood vessel, tumor, or other tissue compressing the glossopharyngeal nerve
- Symptoms and pain intensity are similar to trigeminal neuralgia
- Hemifacial spasm
- A neuromuscular disorder in which frequent involuntary muscle spasms occur on one side of the face
Microvascular decompression surgery is considered the most invasive procedure to treat these conditions, but it is also the best way to fix the underlying problem. Following the surgery, about 80% of patients achieve long-term relief from symptoms.
How Is Microvascular Decompression Surgery Performed?
What to expect during microvascular decompression surgery
Microvascular decompression surgery is performed under general anesthesia.
- After the patient is sedated, a small opening about the size of a quarter is made behind the ear
- The nerve and the “offending” blood vessel are located where they meet
- One or more Teflon sponges are placed in between the nerve and the vessel
- The skin is sutured together and a small bandage is placed
- The procedure typically takes two to three-and-a-half hours.
What to expect after microvascular decompression surgery (recovery)
- After surgery, patients are moved to recovery for an hour or two as they come out of sedation.
- Often, a patient will spend one night in the neurological intensive care unit (neuro-ICU) for close observation. Pain around the incision and mild nausea are common at this point.
- The next day, patients are usually transferred to a regular hospital room. Most patients will spend about two days in the hospital.
- A follow-up appointment at the doctor’s office is usually scheduled for about a week after the surgery.
What Are Risks of Microvascular Decompression Surgery?
Microvascular decompression surgery is considered an invasive procedure, and while infrequent, there are some risks as with any surgery, such as:
- Facial numbness or weakness (usually temporary)
- Hearing loss (usually temporary)
- Infection
- Spinal fluid leak
- Problems with speech or swallowing
- Stroke or hemorrhage (very rare)
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https://www.neurosurgeonsofnewjersey.com/blog/microvascular-decompression/
https://www.ucsfhealth.org/treatments/microvascular-decompression
https://www.ninds.nih.gov/health-information/disorders/hemifacial-spasm