Facial twitching and facial pain are neurological disorders that can cause significant discomfort, interfere with daily activities, and reduce a patient’s quality of life. These conditions are often associated with compression of blood vessels against the facial nerves and therefore require appropriate medical treatment. Today, facial twitching and facial pain can be effectively treated through Microvascular Decompression (MVD) performed by Dr. dr. Mardjono Tjahjadi, Sp.BS, Subsp. N-Vas, F. N-Onk, PhD, FICS, IFAANS (Dr. Joy) at Mandaya Royal Puri Hospital, offering a comprehensive solution that targets the root cause of facial nerve disorders.
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What Is MVD Surgery for Facial Twitching and Facial Pain?
MVD is a surgical procedure designed to relieve pain and muscle twitching caused by pressure from blood vessels—either arteries or veins—on a nerve. This procedure involves opening a small portion of the skull, allowing the surgeon to directly observe the nerve at the base of the brainstem.
Next, a special pad or sponge is placed between the nerve and the compressing blood vessel, protecting the nerve from pulsation and pressure. With this technique, symptoms caused by nerve compression can be significantly reduced.
In practice, the pad used in MVD is commonly positioned between the trigeminal nerve and the superior cerebellar artery or branches of the petrosal vein that are responsible for the compression. Once the pressure on the nerve is relieved, symptoms such as severe pain or facial twitching may subside, leading to an improved quality of life.
Stages of the MVD Procedure
Below is an overview of the stages before, during, and after MVD surgery performed to treat facial twitching and facial pain:
1. Before Surgery
Prior to undergoing MVD, patients will undergo comprehensive medical examinations to ensure their condition is stable and safe for major surgery under general anesthesia. After anesthesia is administered and the patient is asleep, a small area of hair behind the ear on the affected side will be shaved, measuring approximately 2.5 x 7.5 cm. The patient’s head is then carefully positioned and secured with a special stabilizing device throughout the procedure.
2. During Surgery
At this stage, the neurosurgeon creates a small opening in the skull behind the ear, typically about the size of a coin. The protective layer of the brain (dura) is then opened to provide access to the nerve. Using an operating microscope, the surgeon identifies the cranial nerves, particularly the root of the trigeminal nerve connected to the brainstem (pons). In this area, blood vessels are often found compressing the nerve and triggering symptoms.
Throughout the procedure, other medical specialists such as neurologists or neurophysiologists monitor auditory nerve function using specialized equipment. This monitoring is crucial because the auditory nerve pathway is located close to the surgical site and must be carefully preserved.
3. After Surgery
Once the MVD procedure is completed, the patient is transferred to the recovery room for monitoring of vital signs until the effects of anesthesia fully wear off. The patient is then usually admitted to the ICU for one night for close observation. During the early recovery phase, symptoms such as nausea or headache may occur, but these are generally manageable with medication.
When the patient’s condition is stable, care continues in a regular inpatient room. Patients are gradually encouraged to resume light activities, such as sitting up or walking slowly. In many cases, patients are able to return home within 1–2 days after surgery, along with detailed instructions for continued care at home.
Profile and Expertise of Dr. Joy, Neurosurgeon Specialized in MVD
Dr. dr. Mardjono Tjahjadi, Sp.BS, Subsp. N-Vas, F.N-Onk, PhD, FICS, IFAANS, widely known as Dr. Joy, began his medical education at one of Indonesia’s leading universities. Since his student years, he has demonstrated a strong interest in neurosurgery, particularly in the neurovascular subspecialty. After completing his medical education in Indonesia, Dr. Joy pursued his neurosurgical specialist training in Finland, where he studied directly under internationally renowned neurosurgeons and actively participated in cutting-edge research related to brain aneurysms and brain tumors.
Dr. Joy’s academic achievements became even more prominent when he completed his doctoral (PhD) program in Finland in an exceptionally short time—only 18 months and 12 days. This remarkable accomplishment earned him an award from the Indonesian World Records Museum (MURI) as “The Fastest Doctor to Complete a Medical PhD.”
Today, Dr. Joy is widely recognized as one of Indonesia’s leading neurosurgery specialists, with extensive experience in managing complex neurological cases, including brain aneurysms, brain hemorrhages, brain tumors, and brain cancer. Supported by a strong educational background, international experience, and a comprehensive, technology-based medical approach, Dr. Joy has received numerous awards and recognitions at both national and international levels.
Dr. Joy’s Practice Schedule at Mandaya Royal Puri Hospital
The practice schedule of Dr. dr. Mardjono Tjahjadi, Sp.BS, Subsp. N-Vas, F. N-Onk, PhD, FICS, IFAANS at Mandaya Royal Puri Hospital is as follows:
- Monday: by appointment
- Tuesday: 2:00 PM – 5:00 PM (WIB)
- Wednesday: by appointment
- Thursday: 8:00 AM – 12:00 PM (WIB)
- Friday: 2:00 PM – 5:00 PM (WIB)
- Saturday: 8:00 AM – 12:00 PM (WIB)
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