When a blood vessel presses on a nerve and causes symptoms, this is known as neurovascular compression. Microvascular decompression (MVD) is an operation to relieve neurovascular compression of a cranial nerve (a nerve which enters or leaves the brainstem and passes through the skull).
MVD can be used to treat a range of neurovascular compression syndromes including trigeminal neuralgia, glossopharyngeal neuralgia and hemifacial spasm where other non-surgical treatment options, such as medication, have not helped.
MVD is performed under general anaesthetic via a small incision behind the ear. Minimal hair shaving can be used to optimise cosmetic outcome. Under computer image guidance, a small craniotomy (opening of the skull about the size of a 20-cent coin) is made. A state-of the-art specialised operating microscope allows Dr Laban to visualise the nerves as they leave the brainstem without the need for large incisions or retraction. The blood vessels compressing the nerves are identified and separated. Tiny pads of precisely placed Teflon felt can then be used to ensure the nerve is protected from the nearby vessel.
Microvascular decompression is recognised as the most effective procedure for trigeminal neuralgia. It has the best long-term cure rates. 85 – 90% of patients are pain-free immediately following the procedure. 70% of patients remain pain-free for at least 10 to 15 years.
Typically, following surgery, patients can eat and drink and move around independently. Usually, patients are in hospital for three to five days depending on the complexity of surgery and other comorbidities. You can wash your hair two days after the operation. You should avoid dyeing your hair for three months. In general, you should not drive for at least two weeks and until you have made a full recovery following surgery.
All operations carry risk. Risks of MVD include bleeding, infection (including meningitis), CSF leak or disturbance, epilepsy, stroke, death, nerve injury, neurological deficit (pain, numbness, weakness, paralysis, including facial weakness or numbness, hearing loss, visual disturbance or loss, balance problems, taste, speech or swallowing problems), anaesthesia dolorosa, the need for further procedures, venous thromboembolism, and general anaesthetic risks. There is 10 – 15% chance of ongoing pain and 10 – 15% chance of recurrence over 10 to 15 years.
MVD is globally recognised as the gold standard intervention for trigeminal neuralgia. The vast majority of patients are pain-free immediately and back home in a just few days.
Dr Laban is a neurosurgeon with expertise in the treatment of neurovascular compression syndromes including trigeminal neuralgia. If you wish to know more about microvascular decompression, trigeminal neuralgia or any other neurovascular compression syndrome, do contact us today to book an appointment to see Dr Laban on (02) 8320 0577 and get the diagnosis and help you need.