Microvascular Decompression for Glossopharyngeal Neuralgia: Long-term Effectiveness and Complication Avoidance

Abstract

This study demonstrates that MVD is a safe, effective, and durable surgical procedure for producing prolonged pain relief in patients with medically intractable glossopharyngeal neuralgia.

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

“…39 Since that time, this operation has gained greater acceptance than the traditional rhizotomy procedures and many series have been published regard ing its efficacy. [15][16][17]26,30,34,39,[45][46][47]50,56,60,67 Percutaneous procedures have been devised as an alternative to craniotomy; these procedures include ra diofrequency rhizotomy 2,4,12,18,21,40,55 and trigeminal trac totomy. 27,28,38 Most recently, stereotactic radiosurgery has also been explored.…”

Glossopharyngeal Neuralgia Caused by Arachnoid Cyst in the Cerebellopontine Angle

“…The pain is intense and paroxysmal; it originates in the throat, approximately in the tonsilar fossa, and is provoked most commonly by swallowing but also by talking, chewing, yawning, and laughing. The pain may be localized in the ear or radiates from the throat to the ear, implicating the auricular branch of the vagus nerve 18) . Most GPN is assumed to be due to the compression of a cranial nerve by the vessels.…”

“…The pain is similar to trigeminal neuralgia (TN) but is instead localized to the external ear canal, the base of the tongue, the tonsil, or the area beneath the angle of the jaw 18) . The first association between GN and vascular compression of the glossopharyngeal nerve was reported in 1889 by Pope 18) , who described a patient with pain and loss of taste as a result of compression of the glossopharyngeal nerve by a dilated and thrombosed vertebral artery. Shortly thereafter, in 1936, Lillie and Craig 18) described an ture was noted at the CPA.…”

“…The first association between GN and vascular compression of the glossopharyngeal nerve was reported in 1889 by Pope 18) , who described a patient with pain and loss of taste as a result of compression of the glossopharyngeal nerve by a dilated and thrombosed vertebral artery. Shortly thereafter, in 1936, Lillie and Craig 18) described an ture was noted at the CPA. The dorsal wall of the cyst was excised.…”

Use of a strip-clip technique to maintain transposition of a vertebral artery in microvascular decompression surgery

“…Dear Editor, Microvascular decompression (MVD) has become an effective treatment of trigeminal [3,5] or glossopharyngeal neuralgia [7,10] and hemifacial spasm [2,9]. During surgery, a soft implant is commonly used to relieve the nerve or the medulla from the arterial pulsatile pressure.…”