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Microvascular decompression is a surgical procedure that is designed to address the compression of a cranial nerve by a blood vessel. It is most commonly performed to treat trigeminal neuralgia, but can also be used for hemifacial spasm and glossopharyngeal neuralgia. Regardless of diagnosis, the procedure is relatively similar, with respect to the approach and potential complications.
Am I A Good Candidate for Microvascular Decompression?
While some people may be apprehensive about undergoing surgery, it is a highly effective option and considered the gold standard for surgical management of trigeminal neuralgia. The medications available for treating trigeminal neuralgia can provide relief, but over time they can become less effective and produce a number of unwanted side effects. While microvascular decompression is often the first line therapy, it can also the ideal option for individuals who have experienced a recurrence of nerve pain after undergoing other treatment options such as radiofrequency ablation or stereotactic radiosurgery.
The first step in the microvascular decompression process is scheduling a consultation, wherein the patient is asked several questions regarding their condition. Their medical history is discussed, and the symptoms are identified before moving forward.
Patients are encouraged to ask as many questions as they want during the consultation and to bring up any concerns they may have. Subjects such as the cost of the procedure can also be brought up.
What to Expect
A series of diagnostic tests will be performed prior to your procedure to ensure you are healthy enough to undergo the procedure. A list of preoperative instructions will be provided to help prepare you for the surgery. The instructions will include a list of medications and substances to avoid prior to your surgery.
General anesthesia will be administered. The area behind your ear will be prepped and cleaned so that a small incision can be made to allow access to the nerve and blood vessels. A microscope will be used to identify where the nerve is being compressed. Once the problem is identified, a small sponge will be inserted between the nerve and blood vessel to reduce pressure in the area. If the offending blood vessel cannot be identified the nerve may be massaged or partially cut in order to control the pain. The incision will then be sutured closed and covered in a soft dressing.
There is a 95% chance that the procedure will provide immediate pain relief. Up to 70% of patients who have undergone microvascular decompression experience no pain after 10 years. Roughly 10% to 15% of patients who undergo the procedure experience a recurrence of pain after two years.
There are some risks associated with microvascular decompression, but the likelihood of experiencing a complication is very small. These risks include:
- Infection (2%)
- Facial sensory changes (5-10%)
- Spinal fluid leak (5%)
- Hearing loss (1%)
- Stroke (<1%)
Microvascular Decompression Aftercare
Following microvascular decompression, patients will be advised to stay in bed and rest during the first week of the recovery period. There should be no physically taxing activities for at least six weeks, which includes heavy lifting and rigorous exercise. Milder activities such as walking around for five to ten minutes every three to four hours would be fine.
Patients can slowly increase the intensity and the duration of their activities as they recover. Driving will most likely be possible after the first seven days, depending on the results of the follow-up.
Arrange Your Consultation
The ideal way to learn more about microvascular decompression in Dallas and Fort Worth is by scheduling a consultation. Contact the office of Dr. Nader Pouratian today to set up your appointment.