One type of surgery to relieve pressure on the trigeminal nerve (main nerve in the face) is called microvascular decompression (MVD).
The goal of MVD is to relieve pressure by moving blood vessels that are pressing on your trigeminal nerve. This reduces your pain. After your surgeon relieves pressure, the nerve can recover and heal.
Microvascular decompression (MVD) surgery is performed under general anesthesia (you're asleep and usually don't remember the procedure when you wake up). With your head in a secured position your surgeon makes a small incision (cut) behind your ear.
Next, he or she uses a powerful surgical microscope to clearly view the cerebellum (section of your brain near the base of your skull) and see the trigeminal nerve.
During this operation, your surgeon: Exposes your trigeminal nerve root; Identifies the artery causing the pressure; Gently moves the artery away from the point of compression.
Your surgeon positions an implant, usually shredded Teflon®, between the nerve and the artery that's touching it and causing the pain. The Teflon® provides padding to keep the pressure from occurring again.
exposure of the trigeminal nerve root
identification of the responsible artery
displacement from the point of compression
decompression maintained by Teflon® felt
microelectrode lateral x-ray
To make sure that other nerves are not damaged by the surgery, your surgeon carefully monitors your facial and acoustic (hearing) nerve function. He or she does this by inserting gentle needle electrodes (metal wires that conduct mild electrical signals) into the muscles around your eye and mouth.
After the procedure
Following the decompression procedure, your surgeon closes the bony opening behind your ear. You will be awakened and allowed to recover from anesthesia.
Most people stay in the hospital for observation overnight. Usually, you can gradually return to full activity within a few weeks.
Pain relief is usually immediate and medications are gradually discontinued over a two-week period following surgery. Read about Vernon’s story for an inside look into his trigeminal neuralgia treatment experience at OHSU.
Microvascular decompression risks
This procedure is usually safe. Complications from surgery are unlikely but possible and may include:
- Blocking blood supply to your brain stem
- Cerebellar hematoma (blood clot) or swelling
- Hydrocephalus (fluid buildup in the brain)
- Partial facial paralysis
- Hearing loss
- Extra-ocular (outside the eye) partial muscle paralysis
- Leak of fluid from brain and spinal cord area
- Bacterial meningitis (infection)
- Severe headache after surgery
- Death, in rare cases
Be sure to talk to your doctor about the potential risks of your particular procedure.