Robert A. Mericle, M.D. - Microvascular decompression surgery explained
Jonathan White, M.D. - Monitoring function of facial nerve and hearing during a microvascular decompression
Jonathan White, M.D. - Who is a good microvascular decompression candidate?
Jonathan White, M.D. - Microvascular decompression surgery for non-classic trigeminal neuralgia patient
Jonathan White, M.D. - What risks are associated with the microvascular decompression?
Linda Mitchell, R.N. - What type of care is needed after a microvascular decompression?
Jeffrey A. Brown, M.D. - If a microvascular decompression fails, what's next?
Mark E. Linskey, M.D. - If a microvascular decompression fails, what's next?
Robert A. Mericle, M.D. - If a microvascular decompression fails, what's next?
K. Singh Sahni, M.D., F.A.C.S. - If a microvascular decompression fails, what's next?
Jonathan White, M.D. - If a microvascular decompression fails, what's next?
Tony Whitworth, M.D. - If a microvascular decompression fails, what's next?
Bruce E. Pollock, M.D. - Deciding whether or not to repeat the microvascular decompression
Bruce E. Pollock, M.D. - Results of repeating microvascular decompression to explore the trigeminal nerve
   

Microvascular Decompression

The microvascular decompression is major brain surgery done under general anesthesia through an incision behind the ear.  The procedure is done for more than one type of disorder.  Most neurosurgeons monitor the function of the patient’s facial nerve and hearing during the operation.

The goal of microvascular decompression surgery is to find the culprit vessel(s) that is compressing the cranial nerve and move it.  If any artery is compressing the nerve, padding can be placed between the nerve and the artery to hopefully prevent the artery from hitting the nerve in the future.  If a vein is found, padding can be placed between it and the nerve or the nerve can be cauterized.  It is not uncommon to find more than one culprit vessel when exploring the nerve. 

Studies have proven neurosurgeons that do more microvascular decompression surgeries tend to have better results and hospitals that have surgeons who do more procedures tend to have better results for the patients.  Ten microvascular decompressions a year is a reasonable number of microvascular decompression’s done by a neurosurgeon.  Ten, twenty, thirty or even more microvascular decompression’s being done at a hospital each year is practical.

Microvascular decompression patients with classic symptoms have an 80-90% chance of obtaining pain relief which is usually immediate.  This procedure provides the least chance of the pain returning.

articles_ref_org

Treatment of Microvascular Compression Syndromes:  Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Hemifacial Spasm
http://neurosurgery.mgh.harvard.edu/TNHFS/mvd.htm

Technique of microvascular decompression
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.6

Intraoperative three-dimensional visualization in microvascular decompression
http://thejns.org/doi/abs/10.3171/JNS-07/12/1137

Preoperative visualization of neurovascular anatomy in trigeminal neuralgia
http://thejns.org/doi/abs/10.3171/JNS/2008/108/3/0477

Use of fenestrated aneurysm clips in microvascular decompression surgery
http://thejns.org/doi/pdf/10.3171/jns.2007.106.5.929

Significance of the tentorial alignment in approaching the trigeminal nerve and the ventral petrous region through the suboccipital retrosigmoid technique
http://thejns.org/doi/abs/10.3171/JNS-07/11/0932

Microvascular decompression (MVD) - Mayfield Clinic
http://www.mayfieldclinic.com/PE-MVD.htm

Microvascular Decompression Surgery – CCND Winnipeg

Microvascular Decompression (MVD) You Tube video
http://www.youtube.com/watch?v=l4sne6iCriY

Microvascular decompression surgery in the United States, 1996 to 2000: mortality rates, morbidity rates, and the effects of hospital and surgeon volumes.

Studies on the operative outcomes and mechanisms of microvascular decompression in treating typical and atypical trigeminal neuralgia.
http://www.ncbi.nlm.nih.gov/pubmed/15951648?dopt=AbstractPlus

Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression
http://thejns.org/doi/abs/10.3171/JNS-07/12/1144

Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1760596

Brain-stem auditory evoked responses during microvascular decompression for trigeminal neuralgia: Predicting post-operative hearing loss.

Recovery of nerve conduction following microvascular decompression for trigeminal neuralgia
http://cat.inist.fr/?aModele=afficheN&cpsidt=1611862

Patient reports of satisfaction after microvascular decompression and partial sensory rhizotomy for trigeminal neuralgia.

Microvascular decompression after gamma knife surgery for trigeminal neuralgia: intraoperative findings and treatment outcomes
http://jnsonline.org/suppl/issues/v102ss/pdf/n1020259.pdf

Recurrent or refractory trigeminal neuralgia after microvascular decompression, radiofrequency ablation, or radiosurgery
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.13

Repeat posterior fossa exploration for patients with persistent or recurrent idiopathic trigeminal neuralgia
http://thejns.org/doi/pdf/10.3171/JNS/2008/108/5/0916

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