Professor Profyris performs microvascular decompression, a minimally invasive surgical procedure, as a definitive treatment of various cranial nerve disorders and neuralgias. Microvascular decompression provides the most extended duration of trigeminal neuralgia pain relief and the lowest incidence of permanent facial numbness after surgery.  Professor Profyris also has considerable experience with the treatment of hemifacial spasm through microvascular decompression.  This involves decompression of the seventh nerve.  Professor Profyris uses an endoscopic approach for this procedure.


Microvascular decompression is often advised for the treatment of trigeminal neuralgia, a condition that causes severe facial pain due to compression of the trigeminal nerve by a vein or artery surrounding it. It may also be used to treat hemifacial spasms, glossopharyngeal neuralgia and other neurovascular compression syndromes.  The aim of this surgery is to relieve this nerve compression by releasing it and protecting it from further pressure through the placement of a specialised “sponge”.


Professor Profyris performs Microvascular decompression in Johannesburg, South Africa, using a keyhole technique to provide a minimally invasive approach. Professor Profyris performs these procedures endoscopically, which further minimises the foot-print of the operation. The procedure involves a small incision being made behind the ear of the affected side. The skin and muscles are lifted off the bone and retracted. A small opening is made in the skull to expose the dura. A corridor to the nerve at its origin with the brainstem is gently opened. Once the nerve has been located, the blood vessels nearby are moved away to relieve the pressure. Next, a specially designed, microscopic Teflon sponge or pillow is placed over the nerve to protect and prevent the blood vessel from putting pressure on the nerve.  

Microvascular decompression can successfully eliminate or reduce pain caused by neuralgia in the majority of cases; it commonly allows for immediate relief and is often long-term.  Hemifacial spasm is also almost always relieved instantaneously.

This video demonstrates a microvascular decompression performed by Professor Profyris for a patient with severe hemifacial spasm.  The hemifacial spasm resolved instantly post-operatively with no facial weakness.


Is microvascular decompression painful?

As the endoscopic keyhole approach Professor Profyris uses for microvascular decompression requires a small incision and less cutting of the skull than traditional approaches, post-operative pain is significantly less. Most patients only require very simple pain killers.

Is microvascular decompression safe?

Any brain operation can be dangerous. Our aim is to make every surgery as safe as humanly possible through meticulous pre-operative planning, application of keyhole techniques, obsessive attention to operative technique and application of multiple technologies. Professor Profyris and his team will have a detailed discussion about the specifics of your case and potential risks. Professor Profyris performs a significant volume of endoscopic microvascular decompressions.

What are the risks of microvascular decompression?

There are specific risks depending on the exact nerve that is being decompressed as well as general risks related to any brain surgery. Professor Profyris and his team will have a detailed conversation about each of these risks with you

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