What is microvascular decompression?
A microvascular decompression (MVD) is a surgical procedure that treats facial pain due to trigeminal neuralgia. Microvascular decompression is also performed for hemifacial spasm, or other rare pain disorders, including glossopharyngeal neuralgia or geniculate neuralgia.
How is microvascular decompression performed?
A microvascular decompression is performed via a small incision behind the ear, through which a small piece of bone is removed. Through this opening, the nerves at the base of the brain are identified, and a barrier is created between the compressed nerve and the surrounding blood vessels.
Are there risks?
There are always risks associated with any type of surgical procedure. The risks of microvascular decompression include, but are not limited to, bleeding, infection, hearing loss, facial weakness, facial numbness, recurrent or persistent pain or spasms, stroke, spinal fluid leak (possibly requiring the need for additional surgery or procedures), coma and death.
What will happen after the procedure?
Following the procedure, you will be transferred to the post-anesthesia care unit or intensive care unit. Your blood pressure and neurologic exam will be carefully monitored, and you will receive medications to treat any severe pain or nausea that you may experience. In many cases, you may be able to leave the hospital the day after surgery, or you may stay for additional nights until you and your surgical team determine it is safe to be discharged.
What to expect after discharge?
After a short hospital stay, many patients can be safely discharged home with some support from family or friends. In some cases, based on post-operative therapy assessments in the hospital, we may recommend home health services, a skilled nursing facility, or an inpatient rehab facility upon discharge from the hospital.
During the first few weeks after surgery, you should plan to take it easy, but it is important to be up and about and not lying in bed or sitting on a couch or chair all day. It is normal to feel tired after any surgical procedure or anesthetic, and it may take several weeks for this to resolve. Staying active and participating in light exercise is encouraged, but you should avoid strenuous exercise or heavy lifting (of anything more than 5-10 pounds) for at least 4 weeks after surgery. If a bandage/dressing is still covering the incision at the time of discharge from the hospital, it should be removed at approximately 48 hours after surgery. Once the bandage is removed, it is ok to shower, and for the incision to get wet; do not scrub the incision, but you may dab it dry with a clean towel. Do not submerge the incision under water (i.e. no bathing or hot tubs) for at least 2 weeks after surgery.
What should I look out for?
After you are discharged from the hospital, please seek urgent medical attention, or dial 911, if you develop any new weakness or numbness, severe headache, severe nausea/vomiting, seizure, fever >101.1, or increasing redness, discharge or leaking from the incision. In addition, please contact our office or seek urgent medical attention if you notice any fluid leaking from your nose or ear. If you have concerns but are not sure if you should come to the hospital, you may contact our office directly.