User:Tobes2215

Janetta Procedure Microvascular decompression (MVD)

Microvascular decompression (MVD), also known as the Janetta procedure, is the most common surgical procedure for the treatment of trigeminal neuralgia. This is an open surgical approach where a small incision is made behind the ear, a small hole is drilled in the skull, and, under microscopic visualization, the trigeminal nerve is exposed. In most cases, there is a blood vessel (typically an artery, but sometimes a vein) compressing the trigeminal nerve. By moving this blood vessel away from the nerve and interposing a padding made of Teflon felt, the pain is nearly always relieved. While MVD is considered to be the most invasive surgery for TN, it is also the best procedure for fixing the underlying problem that usually causes TN: vascular compression*. MVD also causes the least damage to the trigeminal nerve and provides, on average, the longest pain-free periods and the best chance of being permanently off medication. MVD has a success rate of approximately 80% as a stand-alone treatment. The procedure requires a minimum hospital stay of two to three days, and four to six weeks to return to normal daily activities.

What are the potential side effects of MVD? MVD is a major surgery, and includes the procedure of craniotomy-cutting a small hole in the skull. Typical surgical risks for any open-skull neurosurgical procedure include infection, excessive bleeding, spinal fluid leakage, and risks of anesthesia. Rare neurological injury can include damage to hearing, vascular injury (stroke), and, very rarely, death. Will I have pain when I wake up? As MVD is a major surgery, patients will have some incisional pain and headache postoperatively, but the nurses will give you medication to help you control this pain. How long will I need to stay in the hospital? Patients spend 1 night in the intensive care unit, and 1 to 2 nights in the regular ward. When may I resume normal activities? Pain and stiffness from the operation usually subsides with in a week, and you can begin to resume normal activities at your own pace. Will surgery be completely curative? No one can promise that any surgery for TN will be successful for all patients, and there is always the chance that pain will recur at a later date; however, MVD is the best chance at relieving the underlying problem behind TN pain.