Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery.

Abstract:

:Glossopharyngeal neuralgia (GPN) is an uncommon facial pain syndrome often misdiagnosed as trigeminal neuralgia. The rarity of this condition and its overlap with other cranial nerve hyperactivity syndromes often leads to a significant delay in diagnosis. The surgical procedures with the highest rates of pain relief for GPN are rhizotomy and microvascular decompression (MVD) of cranial nerves IX and X. Neurovascular conflict at the level of the root exit zone of these cranial nerves is believed to be the cause of this pain syndrome in most cases. Vagus nerve rhizotomy is usually reserved for cases in which vascular conflict is not evident. A review of the literature reveals that although the addition of cranial nerve X rhizotomy may improve the chances of long-term pain control, this maneuver also increases the risk of permanent dysphagia and vocal cord paralysis. The risks of this procedure have to be carefully weighed against its benefits. Based on the authors' experience, careful patient selection with a thorough exploratory operation most often leads to identification of the site of vascular conflict, obviating the need for cranial nerve X rhizotomy.

journal_name

Neurosurg Focus

journal_title

Neurosurgical focus

authors

Rey-Dios R,Cohen-Gadol AA

doi

10.3171/2012.12.FOCUS12391

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

E8

issue

3

issn

1092-0684

journal_volume

34

pub_type

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