Microvascular decompression is a special type of brain surgery used to treat facial pain due to trigeminal neuralgia or facial nerve problems. The surgery helps to take pressure off your trigeminal nerve and is considered the definitive treatment for trigeminal neuralgia. In cases of hemifacial spasm, microvascular decompression of the facial nerve is considered a gold standard.
Trigeminal neuralgia occurs when your 5th cranial nerve, called the trigeminal nerve, becomes compressed. When this happens, you may experience symptoms such as:
- Pain on one side of your face, cheek or jaw
- Ear and temple pain
- Sharp, electric-like pain shooting through one side of your face
- Difficulty chewing food, brushing your teeth or talking
If you are experiencing any of these symptoms, see your doctor right away to get an accurate diagnosis of your condition. Trigeminal neuralgia is typically caused by irritation and compression by an artery near the nerve. When this happens, sharp pain or tingling may be felt in your face. Although rare, other problems such as multiple sclerosis or stroke can cause facial pain. That’s why checking in with your doctor whenever facial pain strikes is important.
Initial treatment for trigeminal neuralgia includes using medication and modifying your behavior to avoid activities that may cause your symptoms. If you have persistent trigeminal neuralgia, you should consult a neurosurgeon to discuss your surgical options. Microvascular decompression is one surgery that may be offered to treat your facial pain symptoms.
What is Microvascular Decompression?
Microvascular decompression surgery is done by having your neurosurgeon make a small incision behind your ear. A tiny portion of your skull — about the size of a quarter — will be removed and your trigeminal nerve will be visualized. Then, a small Teflon pad will be inserted between your nerve and the neighboring artery that is compressing it. This takes pressure off your nerve in hopes of relieving your facial pain.
After your nerve is decompressed, the surgical tools will be removed and your incision will be sutured. Then, you can begin your recovery from microvascular decompression.
Preparing for Microvascular Decompression Surgery
The best recovery from surgery begins before you even enter the operating room. Taking time to prepare for your surgery can help you have a positive outcome. Some neurosurgical offices offer a pre-operative class for patients preparing for microvascular decompression surgery. During this class, various topics will be discussed, including:
- Equipment you will encounter in the operating room
- Professional workers who will be involved in your care
- The recovery process after surgery
- A virtual or live tour of the hospital
Having an understanding of the entire surgical process and the people who will be involved in your care can help you feel at ease about your choice to have surgery for trigeminal neuralgia. That way, you can go into surgery with little anxiety about what to expect during and after the procedure.
In the Hospital after Microvascular Decompression Surgery
Immediately after your microvascular decompression, you will be brought to the recovery area where you will be monitored as the general anesthesia wears off. Your nursing staff will measure your vital signs, and your doctor will check on your progress. For the first 24 hours after surgery, you will be closely monitored in the intensive care unit (ICU). Most patients are feeling tired, but well, during this time period; the ICU monitoring is simply a precaution.
After one day in the ICU, you will be moved to a standard hospital room. During your time here, you will be encouraged to get out of bed and start walking to the restroom. You may initially need assistance, but most people find that they can move around independently. Your doctor will check on you during this time and ask you about any symptoms you may be experiencing. Many patients experience rapid relief of facial pain after surgery.
After one day in a standard hospital room, you will likely be well enough to be discharged home to continue your recovery.
Recovery at Home after Microvascular Decompression Surgery
Once you get home from the hospital after microvascular decompression, you can slowly start to increase your activity level. There are a few things you should avoid during the first week after surgery, including:
- Excessive bending over
- Heavy lifting
- Rapid head turning or nodding
- Driving
- House or yard work
You will be encouraged to gradually increase your walking tolerance after microvascular decompression surgery. By the end of the first week, you should be feeling well. You will visit your doctor who will remove the sutures from behind your ear and will check your symptoms.
After you visit your doctor, you will likely be encouraged to gradually get back to your normal activities. You can consider returning to work if your job does not require heavy lifting or high physical demands. You should be back to your normal lifestyle within a few weeks of surgery.
Remember that everyone heals differently from surgery, and your recovery process may take a little longer or be much more rapid. By following the advice of your doctor, you can be sure to recover from microvascular decompression with no negative events.
Does it Matter Who Your Neurosurgeon is for Microvascular Decompression Surgery?
Not every neurosurgeon is a specialist in facial pain or trigeminal neuralgia. Finding a surgeon who treats facial conditions can help you have a positive outcome with surgery. Your doctor should be an expert in the field of trigeminal neuralgia surgery, and he or she should explain every aspect of your surgery with you. You should feel like your neurosurgeon is a trusted ally in your trigeminal neuralgia treatment, so finding the best surgeon is important.
Qualities of a top-rated neurosurgeon include:
- Engages in educational pursuits and research
- Is a facial disorder specialist
- Is a compassionate individual who listens to your concerns about surgery
- Offers you alternatives to treatment
Your neurosurgeon should work closely with you to ensure that you have the best possible outcome with surgery.
Trigeminal neuralgia and facial pain can prevent you from enjoying your normal active lifestyle. The pain can keep you from concentrating on work or keep you from enjoying your time with friends and family.
Microvascular decompression surgery may be the treatment that offers you lasting relief of your trigeminal neuralgia symptoms. By finding a trusted neurosurgeon who treats facial pain syndromes and prepares you for your surgery properly, you can have a positive outcome and be back to your normal lifestyle quickly and safely.
