Microvascular Decompression

On the day of surgery, you’ll get general anesthesia. This medicine puts you to sleep so you don’t feel pain. Your care team will clip a small area of hair behind your ear. Don’t worry — it’ll grow back after the site heals.

The steps may vary a little depending on where and what your surgeon needs to do. But in general, your surgeon and anesthesia team will:

1. Insert a breathing tube through your mouth into your windpipe.
2. Position you on your side.
3. Make a small cut (incision) in the skin behind your ear.
4. Remove a small piece of bone (about the size of a nickel) behind your ear.
5. Open the dura (the thin covering around your brain and spinal cord).
6. Use a microscope or an endoscope to find the compressed nerve.
7. Move the blood vessel away from the nerve.
8. Hold the blood vessel away using either a biologic glue, a sling, a titanium clip or a tiny Teflon™ sponge (soft pad).
9. Close the dura, skull opening and incision site.

When the anesthesia wears off, your care team will remove the breathing tube. They’ll watch you closely to make sure you’re recovering well.

The procedure can take between two and three hours. Your surgeon will give you the best time estimate based on your situation.

Microvascular decompression benefits

This surgery may ease symptoms from certain cranial nerve conditions.

For example, it’s the “gold standard” treatment for trigeminal neuralgia because it treats the cause of the pain, not just the symptoms. Trigeminal neuralgia is a condition that causes severe facial pain that comes and goes. It’s often triggered by things like touching your face, brushing, eating or talking.

Studies show that about 8 to 9 out of every 10 people feel better soon after their procedure. The success rate five years later is 7 to 8 out of every 10 people from the same study.

After surgery, normal activities like chewing, talking and moving shouldn’t cause pain.

Microvascular decompression risks

MVD is a major surgery. Your surgeon makes an opening in your skull, you’ll be under general anesthesia and recovery can take time.

Before surgery, your care team will talk with you about the possible risks. These are rare, but may include:

• Blood vessel injury (stroke)
• Cerebrospinal fluid leak
• Facial numbness
• Hearing loss
• Infection

In some cases, the trigeminal neuralgia symptoms may return after surgery. One study found that pain came back for about 2 out of every 10 people within 10 years.