Microvascular Decompression

Microvascular Decompression (MVD) Surgery

MVD surgery is brain surgery done under general anesthesia. Your surgeon makes a small cut behind the ear and opens a small area of the skull, roughly the size of a quarter, to reach the nerve near the brainstem. Using a surgical microscope, the surgeon finds the blood vessel pressing on the nerve and gently moves it away. A small Teflon sponge is placed between the vessel and the nerve so they no longer touch.

For trigeminal neuralgia, the focus is on the trigeminal nerve. For hemifacial spasm, the focus is on the facial nerve. Many patients feel better soon after surgery, but final results depend on how irritated the nerve was and what the surgeon finds during the procedure.

Microvascular Decompression for Hemifacial Spasm

Hemifacial spasm happens when a blood vessel presses on the facial nerve, which is the nerve that controls the muscles in your face. Every heartbeat sends a pulse to that sensitive part of the nerve, causing involuntary twitching. It often starts around the eye and can spread to the cheek, mouth, and neck over time.

MVD surgery stops that irritation so the nerve can settle down and stop firing abnormally. Some patients notice improvement right away. Others improve gradually as the nerve heals. Because the facial nerve sits near the structures that control hearing, your team will talk with you about steps to protect your hearing and facial function. If you have other symptoms such as facial pain or numbness, your surgeon will evaluate those too to make sure the treatment plan addresses the root cause.

Microvascular Decompression Surgery Length

The microvascular decompression procedure length depends on your anatomy, how many vessels are involved, and whether scar tissue is present around the nerve. In most cases, the surgery takes a few hours from start to finish, followed by time in the recovery room.

Additional time is needed for anesthesia and positioning.

Your surgeon can give you a more specific estimate after reviewing your imaging and discussing your history.

Microvascular Decompression Surgery Recovery

Recovery from microvascular decompression surgery usually starts with an overnight hospital stay. Your team will monitor your neurological status, manage pain, and help you get moving. Most patients move from the recovery room to a step-down unit and go home once they can walk, eat, and manage discomfort with oral medication.

In the days after surgery, it is common to feel tired, have a headache, or notice a sense of fullness in the ear. Your surgeon will walk you through incision care, activity limits, and when you can return to work. Some symptoms clear up quickly. Others improve over weeks as nerve irritation calms down. Your care team will also let you know what to watch for and when to call, including signs like fever, worsening dizziness, or new facial numbness.

Microvascular Decompression Risks

Like all surgeries, MVD carries some risks. These include bleeding, infection, spinal fluid leak, and anesthesia-related complications. Because the surgery is performed near cranial nerves, there is also a chance of temporary or, in rare cases, lasting facial weakness, facial numbness, balance problems, or hearing loss. Serious complications like stroke are very uncommon but will always be discussed openly during your consultation.

Our surgical teams use real-time monitoring and careful technique to reduce risk wherever possible. If you have other health conditions or take blood thinners, those factors will be addressed before surgery.

Microvascular Decompression Scarring

The MVD incision is small, straight, and hidden behind the ear within the hairline. Over time, it typically fades and becomes less noticeable. Right after surgery, some swelling and tenderness around the area are normal.

Your surgeon will let you know when it is safe to wash your hair. General scar care may include keeping the area clean and dry, avoiding sun exposure, and using silicone-based products once the incision has fully healed. If you are prone to thick scarring or have concerns about appearance, bring it up ahead of time so your surgeon can plan accordingly.