MVD (microvascular decompression) is a surgical procedure performed to relieve symptoms such as pain or muscle twitching caused by nerve compression from an artery or vein. The surgery involves opening a small section of the skull to expose the nerves at the base of the brainstem. A small sponge is then placed between the blood vessel and the affected nerve to protect the nerve from pulsation and pressure. This significantly reduces symptoms caused by nerve compression.
During the MVD procedure, the sponge is usually placed between the trigeminal nerve and the superior cerebellar artery or a branch of the petrosal vein. By removing this compression, the patient’s symptoms can be alleviated.
At Mandaya Royal Hospital Puri, MVD is available for conditions such as hemifacial spasm (uncontrollable twitching on one side of the face) and vertigo. The procedure is performed by one of Indonesia’s leading neurosurgeons, Dr. Mardjono Tjahjadi, Sp.BS, Subsp. N-Vas, F. N-Onk, PhD, FICS, IFAANS, better known as Dr. Joy.
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When is MVD Recommended?
MVD can be used to treat:
- Trigeminal neuralgia
- Hemifacial spasm
- Glossopharyngeal neuralgia
Because MVD requires general anesthesia and involves brain surgery, it is not considered the first-line treatment. Doctors typically recommend MVD when:
- Symptoms are severe and significantly affect quality of life
- Conservative or non-surgical treatments are no longer effective
- Patients cannot tolerate the side effects of medications
How is the MVD Procedure Performed?
1. Before the procedure
Prior to surgery, the patient undergoes medical evaluations to ensure they are fit for a major operation under general anesthesia. Once anesthetized, a small area of hair behind the ear (about 2.5 x 7.5 cm) on the affected side is shaved. The patient’s head is positioned and secured to remain stable during the operation.
2. During the procedure
The neurosurgeon makes a small opening in the skull behind the ear, about the size of a coin, and carefully opens the dura (the protective brain membrane). Using a microscope, the surgeon identifies the cranial nerves, especially the root of the trigeminal nerve connected to the brainstem (pons). In most cases, a blood vessel compressing the nerve is found here.
Throughout the surgery, a neurologist or neurophysiologist monitors special equipment to check the function of hearing nerves in the area, since they are located close to the surgical site.
3. After the procedure
Once the surgery is complete, the patient is moved to the recovery room for close monitoring until they wake up from anesthesia. They are then transferred to the ICU for one night of observation. Some patients may experience nausea or headaches initially, but these symptoms can usually be managed with medication.
When stable, the patient is moved to a regular ward and encouraged to perform light activities such as sitting up or walking slowly. In most cases, patients can be discharged within 1–2 days with instructions for home care.
Successful Treatment of Hemifacial Spasm and Vertigo with MVD at Mandaya Royal Hospital Puri
Mandaya Royal Hospital Puri has successfully performed MVD procedures for patients with hemifacial spasm and vertigo, led directly by Dr. Joy. Recently, Dr. Joy also received a MURI (Indonesian World Record Museum) award for becoming the fastest PhD graduate in Medicine.
1. MVD for Hemifacial Spasm
A 46-year-old patient from Cijantung, East Jakarta, shared her experience battling hemifacial spasm on the left side of her face for 3–4 years. The condition caused uncontrollable twitching on her left cheek, disrupting her daily activities.
She had tried various treatments, including medication and botox injections. Although the botox provided temporary relief, the twitching always returned after the effects wore off.
Since undergoing MVD surgery, the patient has not experienced facial twitching again.
“From the moment I woke up from surgery, the twitching never came back — even until today,” she shared with relief.
2. MVD for Vertigo
Another patient suffered from chronic vertigo for more than two years, with symptoms including severe dizziness, nausea, vomiting, and weakness. The vertigo attacks often came suddenly, even while working or riding a motorcycle — once even causing an accident. At its worst, the patient had to be hospitalized due to persistent vomiting and severe dehydration.
Despite years of treatment with medications from neurologists, the vertigo persisted. Some doctors even considered the case untreatable. However, after undergoing MVD surgery with Dr. Joy, the results were remarkable. The vertigo attacks completely stopped, tinnitus gradually improved, and even two months post-surgery, the patient remained symptom-free. The surgical wound also healed well without pain or complications.
Expertise of Dr. Joy at Mandaya Royal Hospital Puri
In addition to MVD, Dr. Joy is also highly skilled in performing Awake Brain Surgery (brain surgery while the patient is conscious), DSA, and microsurgery.
Clinic schedule of Dr. Joy (Dr. Mardjono Tjahjadi, Sp.BS, Subsp. N-Vas, F. N-Onk, PhD, FICS, IFAANS):
- Monday: By appointment
- Tuesday: 14:00 – 17:00 WIB
- Wednesday: By appointment
- Thursday: 08:00 – 12:00 WIB
- Friday: 14:00 – 17:00 WIB
- Saturday: 08:00 – 12:00 WIB
To consult directly with Dr. Joy about MVD, hemifacial spasm, or vertigo, visit Mandaya Royal Hospital Puri.
For easier access, use the WhatsApp Chat, Book Appointment, or the Care Dokter app, available on Google Play and the App Store, to check queues and get complete hospital information.
