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

Roberto Rey-Dios, Aaron Cohen-Gadol

Research output: Contribution to journalArticle

35 Citations (Scopus)

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 thechances 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.

Original languageEnglish
Article numberE8
JournalNeurosurgical Focus
Volume34
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Glossopharyngeal Nerve Diseases
Microvascular Decompression Surgery
Rhizotomy
Vagus Nerve
Cranial Nerves
Pain
Blood Vessels
Facial Neuralgia
Glossopharyngeal Nerve
Vocal Cord Paralysis
Trigeminal Neuralgia
Deglutition Disorders
Diagnostic Errors
Patient Selection
Conflict (Psychology)

Keywords

  • Cranial nerve
  • Glossopharyngeal neuralgia
  • Microvascular decompression
  • Rhizotomy
  • Vagus nerve

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

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