Minimally Invasive Technique Relieves Severe Face Pain

Ruzanna Harutyunyan's picture

Jeff Jackson, 49, of Troy, began having face pain about two years ago. At first the pain was annoying, but later it became more frequent and at times intolerable.

"It felt like a red hot ice pick with 220 volts running through it," Jackson explained. "And after the pain went away, I always worried when it might return. It was terrible."

Along with the pain was an 18-month journey to find its cause. Jackson initially thought the pain resulted from his teeth, but later found out it was a condition called "trigeminal neuralgia" or "TN." It was then he heard about neurosurgeon Daniel Pieper at Beaumont Hospital, Royal Oak, who performs minimally invasive surgery to relieve TN.

TN is a disorder of the trigeminal nerve, which is responsible for the feeling in your face. In most cases, the facial pain is caused by a blood vessel pressing on the nerve. Some believe TN is caused by the deterioration of the protective covering (myelin sheath) of the trigeminal nerve. While dental procedures do not cause TN, it is believed they often trigger the pain.


Jackson was convinced he wanted the surgery after meeting with Dr. Pieper and learning about his advanced surgical technique. During the procedure, endoscopic microvascular decompression, a small scope is inserted behind the ear and used to find the blood vessel pressing on the trigeminal nerve. Once identified, small Teflon pads are placed between the nerve and the vessel to relieve the pressure.

Microvascular decompression is not new. Dr. Pieper is one of the few surgeons nationwide performing this surgery with a scope, however. This approach has many advantages compared with traditional microvascular decompression: surgical time is cut in half; a patient's hospital stay is shorter; and his recovery period is also reduced, allowing him to return to work and normal activities within a few days as compared to weeks. Dr. Pieper does not need to move the patient's brain as in the traditional surgery for TN.

When Jackson awoke from his surgery his face pain was gone. Dr. Pieper remembers his patient flashing an enthusiastic thumbs-up after seeing him in the recovery area.

Says Jackson, "For the first time in two years, I'm feeling normal again." A golf enthusiast, he hit the links only 12 days after his surgery.

Endoscopic brain surgery is used to treat small tumors and diseases or malfunctions of the nerves at the base of the skull in addition to TN.