Microvascular Decompression (MVD) is a surgical treatment designed to treat facial pain or facial spasm that is refractory to medical therapies.
This microsurgical technique involves protecting important nerves, known as cranial nerves, with small Teflon sponges. In specific instances, small arteries and/or veins irritate these critical nerves by pushing on them. This anatomical relationship is often referred to as a “neurovascular conflict”.
Pressure on one or more nerves can cause severe pain as well as painful muscle spasms. MVD is most often used in the treatment of trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia.
During MVD, surgeons separate the painful nerve from the offending vessel using a tiny Teflon sponge, thus relieving the pressure and allowing the nerve to heal.
MVD involves the use of general anesthesia and brain surgery and is therefor not typically the first line of treatment. However when the condition is extreme and/or more conservative care has been exhausted, this procedure can be extremely effective.
Before the Procedure
- Notify your physician if you are sensitive to or are allergic to any medications, latex, tape, contrast dyes, iodine, shellfish, or anesthetic agents (local and general).
- Notify your physician of all medications (prescription and over-the-counter) and supplements that you are taking.
- Notify your physician if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
- Notify your physician if you have any type of implant(s), such as a pacemaker and/or implantable defibrillator, artificial heart valve, surgical clips for a brain aneurysm, implanted medications pump, chemotherapy port, nerve stimulators, eye or ear implants, stents, coils, or filters.
- If you are pregnant or suspect that you are pregnant, you should notify your physician. Women of child-bearing age may be asked to give a urine specimen for pregnancy testing prior to the procedure.
- You will be asked to fast for eight hours before the procedure, generally after midnight.
- You may be given a special shampoo to wash your hair with the night before or the morning before the procedure.
- You may receive a sedative prior to the procedure to help you relax.
- Based upon your medical condition, your physician may request other specific preparation.
During the Procedure
- You will be asked to remove any clothing, jewelry, hairpins, dentures, or other objects that may interfere with the procedure, and will be given a gown to wear.
- An intravenous (IV) line may be started in the hand or arm in order to give medications and/or fluids during the procedure.
- You will be put to sleep with General anesthesia.
- The surgeon will then make an incision behind your ear on the side of your head where your symptoms are.
- A small piece of bone will be temporarily removed so that the surgeon can access your brain.
- Using an operative microscope, the surgeon will carefully navigate the area and isolate the nerve that is causing the pain, most often the Trigeminal nerve.
- The surgeon will then secure a small Teflon sponge between the nerve and the blood vessel believed to be causing the compression and pain on the nerve.
- Once this procedure is complete the surgeon will replace the the bone and close up the wound and you will be taken to the Neuro Intensive Care Unit for observation.
After the Procedure
- After the procedure, you will be observed for a period of time.
- Once you are able to take liquids by mouth, the IV line will be removed. You may take liquids and solid foods as tolerated.
- You may feel some discomfort after the procedure, such as a headache or nausea. Let your nurse know if you are uncomfortable, so that you may be given medication and/or other treatment.
- Your hospital stay will typically last a few days and you will need to have someone drive you home.
- Once you are home, you may resume your normal diet, medications, and activities, unless your physician instructs you differently. You may be instructed to avoid strenuous activity, such as exercise, for a period of time.
Call your physician to report any of the following:
- Severe headache that is not relieved by medication
- Facial weakness
- Hearing loss
- Excessive drainage and pain at the incision site
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.