Microvascular decompression for glossopharyngeal neuralgia

Daniel K. Resnick, Peter J. Jannetta, David Bissonnette, Hae Dong Jho, Giuseppe Lanzino

Research output: Contribution to journalArticle

139 Scopus citations

Abstract

GLOSSOPHARYNGEAL NEURALGIA IS an uncommon cause of facial pain with a relative frequency of 0.2 to 1.3% when compared with trigeminal neuralgia. It is characterized by intermittent, lancinating pain involving the posterior tongue and pharynx, often with radiation to deep ear structures. Since its first description in 1910 by Weisenburg, a variety of destructive procedures have been performed to provide relief in patients whose pain was refractory to medical treatment. These procedures all necessitated the sacrifice of the glossopharyngeal nerve and, in most cases, also involved the destruction of at least part of the vagus nerve as well. In 1977, Laha and Jannetta reported good results in four patients who underwent microvascular decompression of the glossopharyngeal and vagus nerves for glossopharyngeal neuralgia. Since 1971, 40 patients have undergone microvascular decompression of the glossopharyngeal and vagus nerves for treatment of typical glossopharyngeal neuralgia. This procedure provided excellent immediate results (complete or >95% relief of pain) in 79%, with an additional 10% having a substantial (>50%) reduction in pain. Long-term follow-up (mean, 48 mo; range, 6–170 mo) reveals excellent results (complete or >95% reduction in pain without any medication) in 76% of the patients and substantial improvement in an additional 16%. There were two deaths at surgery (5%), both occurring early in the series as the result of hemodynamic lability causing intracranial hemorrhage. Three patients (8%) suffered permanent 9th nerve palsy. These results demonstrate that microvascular decompression of the glossopharyngeal and vagus nerves is an effective treatment for glossopharyngeal neuralgia and can be performed safely in centers experienced in the neuroanesthetic treatment of posterior fossa surgery.

Original languageEnglish (US)
Pages (from-to)64-69
Number of pages6
JournalNeurosurgery
Volume36
Issue number1
DOIs
StatePublished - Jan 1995

Keywords

  • Cranial nerve diseases
  • Glossopharyngeal nerve
  • Microsurgery
  • Pain

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Resnick, D. K., Jannetta, P. J., Bissonnette, D., Jho, H. D., & Lanzino, G. (1995). Microvascular decompression for glossopharyngeal neuralgia. Neurosurgery, 36(1), 64-69. https://doi.org/10.1227/00006123-199501000-00008