Microvascular
decompression (MVD) surgery is performed under general anesthesia, through an incision
and small thumbprint sized bony opening behind the ear. An operative
microscope is used to visualize the facial nerve root entry zone.
Microsurgical
instruments and techniques are used to mobilize vessels compressing
the facial nerve root entry zone, and thus alleviate the neurovascular
compression. The offending vessels are permanently
maintained in their new position away from the facial nerve with placement
of inert implants. We use shredded Teflon® felt for this purpose.
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Prior
to MVD. |
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During
MVD, the vessel is mobilized away from the nerve root entry zone.
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The
decompression is maintained with shredded Teflon® felt implants. |
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MVD
has resulted in permanent alleviation of the neurovascular compression.
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When vascular decompression is completed, the
dura, the bony opening and the incision are closed. The patient is then
awoken from the anesthetic and is taken to the recovery room. Our average
duration of hospitalization for MVD is three and a half days, and most
people return to their full level of activity and employment within
two to eight weeks.
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Inert
shredded Teflon®
felt implants
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Operating
microscope
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Microvascular decompression of the facial
nerve root entry zone eliminates the irritation causing HFS. This allows
the hyperactivity of the facial nerve nucleus to settle towards a normal
condition. While spasms may disappear immediately after surgery, usually
the HFS gradually subsides and is cured over a course of several weeks
or months.
In our experience, over 85% of
patients with typical HFS are cured with MVD surgery, and another 5-10%
have significantly reduced spasms. The risks of surgery have been small,
and routine use of Intra-Operative
Monitoring has been credited with greatly enhancing the
safety of MVD. Hearing loss, new weakness of the face and swallowing
difficulties are rare, and usually dissipate. Other rare complications
include infection, inflammation and healing difficulty leading to CSF
leak. The risk of serious MVD surgery complications due to stroke, bleeding,
or brain swelling have been less than 1 in 300.
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