Facial Pain and Spasm (Trigeminal Neuralgia and Hemifacial Spasm) Center
Our Facial Pain and Spasm Center, directed by Dr. Joung H. Lee, focuses on management of trigeminal neuralgia (TN) and hemifacial spasm (HFS), as well as less common geniculate neuralgia and glossopharyngeal neuralgia. Dr. Lee is a leading international authority in the subspecialty of skull base surgery who comes from the world-famous Cleveland Clinic where he served as Professor and the founding Director of the Cleveland Clinic Skull Base Surgery Center since July 1993. At the Cleveland Clinic, he had established one of the most respected skull base surgery programs in the world. During his 21-year tenure there, included in his extensive skull base surgery experience which number well over 4000 cases, he had performed well over 1000 operations in patients with TN and HFS.
He has authored more than 100 publications and edited two books, including a comprehensive textbook on meningiomas (Springer-Verlag, 2008, 616 pages). In the last 24 years, in addition to training Cleveland Clinic neurosurgery residents, he has trained over 24 research and clinical fellows in skull base surgery. His published outcomes data set the standard for the field of neurosurgery in complex brain and skull base surgery.
First and foremost, for patients with facial pain or spasm, it is critically important to have a correct diagnosis established by an experienced clinician. After having a correct diagnosis, it is equally important for these patients to know all treatment options. These include, for TN patients, medical therapy, microvascular decompression (MVD), glycerol rhizotomy, balloon compression rhizotomy, radiofrequency rhizotomy, Gamma Knife Radiosurgery, and peripheral trigeminal nerve sectioning (neurectomy). For HFS patients, treatment options include Botox injections and microvascular decompression (MVD). Careful analysis of the individual patient’s age, medical condition and symptom severity must be conducted by an expert surgeon experienced in all management options to come up with an individualized treatment plan tailored for each patient.
In performing a microvascular decompression, if selected as the best treatment option for an individual patient, the surgeon’s experience is a critically important factor in determining the patient’s overall successful outcome as the operation involves delicate manipulation under an operating microscope (i.e. microsurgery) of important cranial nerves that are responsible for facial sensation, hearing, balance and facial movement.
Minimally invasive surgery is performed in an MVD in our program, performed in an hour or less, through a 4-cm incision behind the ear, through a 2-cm bone opening (suboccipital “craniotomy” or “craniectomy”). Hospital stay is usually 1 or 2 days.
It is our mission to deliver world-class care to each and every patient with respect and compassion. We strive to treat each patient as if he or she is our own family member.