Microvascular decompression (MVD) is a minimally invasive surgical procedure that relieves abnormal compression of a cranial nerve and is performed to treat trigeminal neuralgia (often caused by pressure on the trigeminal nerve from a blood vessel, usually the superior cerebellar artery), vagoglossopharyngeal neuralgia, and hemifacial spasm.
PROCEDURE
Under general anaesthesia, the skin is incised behind the ear and a 3-cm craniotomy performed. The trigeminal nerve is exposed and the vascular elements compressing the nerve are identified. An appropriate size of teflon sponge is then inserted between the nerve and the vessel. This sponge isolates the nerve from the pulsating effect and pressure of the blood vessel. Sometimes a vein is adherent to the nerve, causing compression. In these cases, the vein is cauterized and moved away.
DURATION
The operation generally takes 2 to 3 hours. Hospital stay is of 3-7 days.
RECOVERY
90% of the patients experience complete relief. Pain may recur in 5-20% of the patients. Normal activity can be resumed gradually. Heavy work is to be avoided for 6-8 weeks.
RISKS
General complications of any surgery include bleeding, infection, blood clots, and reactions to anaesthesia. Specific complications related to a craniotomy may include stroke, seizures, swelling of the brain, and CSF leak. Those related to MVD are due to nerve damage, and include hearing loss, double vision, facial numbness or paralysis, hoarseness, and unsteady gait.