Microvascular decompression surgery treats the pain of certain nerve conditions that affect the head and neck. The surgery-related risks are few, and many people report an immediate reduction in pain.

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Microvascular decompression surgery, also known as the “Jannetta procedure,” can reduce pain and muscle twitching in the head and neck area that can occur from vascular nerve compression.

The procedure is done under general anesthesia and takes a few hours. Microvascular decompression surgery is considered safe and has few surgery-related risks.

Learn more about preparing for the procedure, what to expect on the day, and how long recovery may take.

Microvascular decompression is a surgical procedure that aims to relieve pain from conditions that cause neurovascular nerve compression. These conditions may include:

  • Trigeminal neuralgia: Trigeminal neuralgia is the most common reason for needing microvascular decompression. This condition occurs when a blood vessel puts pressure on the trigeminal nerve, which runs along the side of the face. People with this condition may feel sharp pain.
  • Glossopharyngeal neuralgia: Glossopharyngeal neuralgia is caused by pressure on the glossopharyngeal nerve, which runs through your brain stem, mouth, and neck. People with this condition often report pain in the inner ear, mouth, and throat.
  • Hemifacial spasm: Hemifacial spasms are muscle spasms that happen on either the right or left side of the face. There are many possible reasons for this symptom, and sometimes it occurs when a blood vessel puts pressure on a nerve.

A doctor will talk with you about the specific steps you’ll want to take before your surgery.

Some steps may depend on your individual circumstances. For instance, you might take medications that a doctor will advise you to pause a few days before surgery. Common medications to stop taking include blood thinners and anti-inflammatory medications.

General steps to prepare for surgery often include:

  • An MRI scan and other brain imaging tests: It’s common for doctors to require images of your brain before a microvascular decompression procedure.
  • Brainwave monitoring: A brainwave monitoring test is used to get a baseline of your brain activity. Doctors will then use it to monitor your nerves during surgery.
  • A discussion about your medications: It’s important to discuss all your medications with a doctor before any procedure to rule out any interactions.
  • Avoiding alcohol and smoking for at least a week: Alcohol and nicotine can both interact with healing after surgery. It’s recommended to avoid both substances for at least a week before surgery.
  • Washing your hair and scalp: A doctor may give you a special antibacterial shampoo or soap to wash your hair and scalp with before surgery, which can reduce the risk of infection.
  • Not eating on the day of surgery: A doctor will give you an exact timeline, but often people having microvascular decompression surgery are asked to not eat anything after midnight on the night before their surgery.

The procedure for microvascular decompression typically takes between 2 and 4 hours. You’ll receive general anesthesia before the procedure begins. Once you’re safely under anesthesia in the operating room, the procedure will begin.

During the procedure, a surgeon will:

  1. make an incision in your skin to expose your skull
  2. remove a small piece of your skull to expose the outer covering of your brain, called the “dura”
  3. make an incision in the dura
  4. carefully maneuver through the created space to find and expose the cranial nerve and blood vessel
  5. decide the appropriate technique to separate the nerve and blood vessel
  6. use one of the following techniques:
    • use a sling to pull the blood vessel and nerve apart
    • place a small sponge between the blood vessel and nerve
    • reroute the blood vessel so that it no longer affects the nerve
  7. close the dura
  8. replace the piece of skull
  9. use small stitches or staples to close the scalp

Most people stay in the hospital for 1 to 3 days after this procedure. It’s common to experience almost immediate relief after microvascular decompression, but it typically takes a few weeks for symptoms to resolve completely.

There’s often some pain and stiffness from the microvascular decompression. Lingering effects, such as facial numbness, fatigue, and muffled hearing, are also common. These effects generally resolve in about a week. Your stitches or staples will be removed in about 2 weeks.

It’s typically safe to resume activities such as work, school, and daily at-home tasks as soon as you feel up to it, but a doctor might advise you to wait at least a month before driving on your own.

A doctor can help you understand the safest timeline for your recovery.

Microvascular surgery is considered safe, but all surgical procedures are linked to some risks. The risks of microvascular surgery can include:

How effective is microvascular decompression?

Microvascular decompression surgery is typically a very effective procedure. Many people who have the procedure report feeling immediate relief.

What is the mortality rate of microvascular decompression surgery?

The mortality rate after microvascular decompression is very low and typically falls between 0.2% and 0.5%.

Is microvascular decompression a serious surgery?

Microvascular decompression can be considered a serious surgery because it involves a surgeon making a hole in your cranium, which are the bones surrounding your brain.

Microvascular surgery is a procedure that can help treat conditions that affect the nerves in your face and skull. Most people who have this procedure find that their pain is reduced.

Typically, microvascular surgery lasts for 2 to 3 hours, followed by a hospital stay of about 1 to 3 days. Recovery can vary depending on your specific circumstances, but complete pain relief is typically experienced within 1 week.