Microvascular Decompression Surgery For Trifacial Neuralgia: What You Need To Know

Microvascular decompression (MVD) has become the leading surgical option for treating trigeminal neuralgia. This procedure effectively separates nerve and vascular adhesions while relieving pressure from blood vessels on the nerve. Patients often experience immediate pain relief, with clinical success rates ranging from 90% to 98%. Long-term outcomes remain favorable at approximately 85%, with a recurrence rate between 5% and 10%. Notably, no patients typically experience symptom worsening following the surgery.

Understanding The Surgical Procedure

Today, MVD is considered both a classic and highly refined technique. As a minimally invasive procedure, surgeons typically make a 4-5 cm incision behind the ear and create a small opening in the skull, roughly the size of a one-dollar coin. Most patients recover quickly, with hospital stays lasting only 4 to 5 days. The average cost of this procedure is around $30,000, making it a cost-effective solution for long-term relief.

Potential Side Effects And Complications

While complications are rare due to advancements in surgical equipment and techniques, some patients may experience temporary side effects. These can include short-term facial numbness or mild dizziness after surgery. In rare cases, patients might encounter cerebrospinal fluid leakage or minor bleeding. However, these issues occur in only 1% to 2% of cases, and most are easily managed with proper care.

Causes Of Primary Trigeminal Neuralgia

Primary trigeminal neuralgia typically occurs when blood vessels compress the trigeminal nerve near its origin from the brainstem. This compression usually affects the nerve root and is most commonly caused by the superior cerebellar artery. Other potential causes include an enlarged basilar artery or vertebral artery. In about 6% of cases, the compression involves a vein rather than an artery. Approximately 95% of trigeminal neuralgia cases are classified as primary, with vascular pressure causing visible changes in the nerve structure. These changes may include the nerve transforming from a round to a flattened shape, with the nerve sheath changing from white to yellow in appearance. Localized adhesions may also develop as a result of prolonged compression.