Is MVD surgery risky?
This is a transcript of an interview with Dr Jaydev Panchwagh, neurosurgeon. This was aired on TV. He is the Director of the MVD Centre in Pune.
Trigeminal Neuralgia: General Information
Interviewer: Doctor, I read up some articles on Trigeminal Neuralgia before this interview. It appears that the patients are affected by a very severe kind of pain in the face.
Dr Jaydev Panchawagh: Yes!! The pain is so severe and comes so suddenly that some patients even contemplate suicide!! The pain is variously described as sharp, stabbing, burning, shock-like etc.
Trigeminal Neuralgia: Treatment choices
Interviewer: I also read that there are many kinds of treatments available, but none really effective. Is that correct?
Dr Jaydev Panchawagh: Treatment of Trigeminal neuralgia is usually started with medicines (tegretol, Carbamazepine). Initially they are effective. But over a period of time, the pain takes over. We need to increase medicine doses. The pain gets controlled. Then over the next few months, medicines lose their effectiveness. The doses need to be further increased or medicines changed. This goes on till the pain becomes unbearable or the medicine’s side effects are not tolerated. The patient then has to consider other options. But in our MVD Centre, we often give the option of surgery before very high doses of medicines are reached. Because, the side effects are at this time unacceptable.
There are other treatment options like RFLG, nerve Blocks , balloon compression , or Gamma knife radiation but my particular preference has generally always been MVD surgery.
Trigeminal Neuralgia: MVD surgery
Interviewer: So, is MVD surgery a brain surgery?
Dr Jaydev Panchawagh: Yes, MVD or MicroVascular Decompression surgery is a brain surgery. The operation is performed where the Trigeminal nerve exits from the brainstem. It is in a very deep part of the brain.
Interviewer: Is MVD surgery risky?
Dr Jaydev Panchawagh: It is fairly safe in the hands of an experienced surgeon. The more MVD surgeries one performs, the more comfortable one becomes with the anatomy there. We become more aware of what to expect, what to do, what not to do. So the chances of success in the surgery also is much higher than in the hands of an inexperienced surgeon. This is one of the reasons why MVD surgery is best done at Centres which have a high volume of these surgeries.
Why experienced neurosurgeon matters?
The patient must therefore find out how many such surgeries the surgeon has performed. The potential risks could be infection, bleeding, hearing loss, facial numbness, and/or facial weakness (generally temporary), CSF leak, difficulty to talk/ swallow, stroke/ paralysis/risk to life (extremely rare).
Interviewer: Doctor, how many MVD surgeries have you performed so far?
Dr Jaydev Panchawagh: I have performed more than 1600 surgeries so far (from 2002 to 2022). You can access the testimonials of some of the patients here.
Interviewer: What is the aim of MVD surgery?
Dr Jaydev Panchawagh: The final goal is to prevent pain that arises because of compression of the Trigeminal Nerve either by a blood vessel or by brain tumors.
Interviewer: Is MVD performed for treatment of Trigeminal neuralgia alone?
Dr Jaydev Panchawagh: No, MVD can be performed for treatment of Hemifacial spasm ( affecting the Facial nerve) or Glossopharyngeal Neuralgia(affecting the glossopharyngeal nerve). You can know more about this in my video explaining Hemifacial spasm symptoms and causes.
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You may watch this video to know more about Glossopharyngeal neuralgia .