What Causes

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     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.

Where the hole is made behind the ear.

The hole made behind the ear.

    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.

Prior to MVD.   During MVD, the vessel is mobilized away from the nerve root entry zone.
The decompression is maintained with shredded Teflon® felt implants.   MVD has resulted in permanent alleviation of the neurovascular compression.

     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.

Teflon® felt implants
Operative microscopes used during the procedure
Inert shredded Teflon® felt implants
Operating microscope

     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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Prepared by A. M. Kaufmann, T. Lye & M. Patel
© 2001 Centre for Cranial Nerve Disorders, Winnipeg, University of Manitoba, Health Sciences Centre. The information provided on this web-site is intended for educational purposes only, and should not be used to diagnose or treat a disease or disorder. This information is not intended to substitute, supplement, or in any way qualify the services or advice provided by a qualified health care professional. Please consult with a certified health care professional before pursuing any form of medical action. Duplication in any part or form of this document is strictly prohibited. All rights reserved. For further information please read our disclaimer. Web-Site related inquiries can be directed to the Information Provider.