Microvascular decompression (MVD) is a surgical procedure to relieve the symptoms of trigeminal neuralgia.

Microvascular decompression (MVD), also known as the Jannetta procedure, is a surgical procedure to relieve the symptoms of trigeminal neuralgia. In this procedure, the neurosurgeon surgically opens the skull, (a craniectomy), exposing the nerve at the base of the brainstem to insert a tiny sponge between the compressing vessel and the trigeminal nerve. This sponge isolates the nerve from the pressure and pulsating of the blood vessel. By alleviating and removing the neurovascular compression, the trigeminal nerve recovers and painful symptoms are relieved. The process does not damage or destroy the nerve.

This procedure was pioneered by Peter Jannetta, MD, who graduated from medical school at the University of Pennsylvania. Dr. Jannetta successfully performed his first procedure in 1966 and eliminated the facial pain of a 41-year-old man. It took a long time before the medical community accepted and adopted this procedure. However, once it was adopted, many of the neurosurgeons performing the procedure were trained by Dr. Jannetta, including Dr. Lee.

Microvascular decompression (MVD) surgery is performed under general anesthesia, through an incision and small thumbprint sized bony opening behind the ear. The surgeon peers into the opening through an operative microscope, looks around the cerebellum, and visualizes the trigeminal nerve as it arises from the brain stem.

Micro-instruments are used to mobilize the offending vessels away from the trigeminal nerve root. The decompression is permanently maintained by inert implants between the vessels and nerve.

Following the microvascular decompression, the bone and incision are closed. Most patients then remain in the hospital for two or three days, and gradually return to full activities within a few weeks.

Pain relief is usually immediate, and medications are gradually discontinued over two weeks following surgery. If pain does recur, it may be more easily treated with medications than before, or retreated with any of the neurosurgical procedure options.

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