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

Rey‐Dios, Roberto; Cohen-Gadol, Aaron

doi:10.3171/2012.12.focus12391

Cited by 87 publications

(78 citation statements)

References 75 publications

(64 reference statements)

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“…When medical therapy cannot control pain effectively or side effects of medications become intolerable, surgical intervention is considered. [16,17] Rhizotomy of the glossopharyngeal nerve and MVD are usually carried out with high rates of pain relief (80%–90%), [11,18,19] but persistent lower cranial nerve damage has been reported for 8% to 19% of patients, [19,20,21] and 5% risk of mortality. [22] At the same time, for older patients with GPN, the majority of them had some age-related disorders, and they were not suitable for or refused to surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Microvascular decompression (MVD) for GPN is an option with good rates (80%–90%) of pain relief. [11] However, permanent lower cranial nerve damage and significant mortality can occur with open surgery. [3,12] Percutaneous radiofrequency thermocoagulation (PRT) is a well-accepted treatment for neuropathic pain, [13–15] especially for its safety.…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcomes of percutaneous radiofrequency thermocoagulation for glossopharyngeal neuralgia

Wang

Tang²,

Zeng³

et al. 2016

Medicine

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The aim of this study was to investigate the long-term results of computed tomography (CT)-guided percutaneous radiofrequency thermocoagulation (PRT) for glossopharyngeal neuralgia (GPN).A retrospective review of medical records for patients with GPN who were treated with CT-guided PRT between 2003 and 2014 was performed to investigate baseline characteristics and immediate outcomes during the hospitalization. Long-term pain relief outcomes and complications were obtained via telephone survey. Duration of pain-free was assessed by Kaplan–Meier analysis.Eighty patients with GPN were treated with CT-guided PRT, and 71 patients could be contacted for the follow-up. The mean length of follow-up after PRT was 56.2 ± 43.3 months. Pain relief occurred in 63 patients (78.8%) immediate after the PRT procedure. The percentage of patients who remained in an “excellent” or “good” pain relief condition was 73.2%, 63.0%, 53.2%, and 43.0% at 1, 3, 5, and 10 years. Postprocedure complication included dysesthesias, dysphagia, and diminished gag reflex. No mortality was observed during or after PRT procedures.This study indicates that CT-guided PRT is a safe and effective method for patients with GPN and should be considered as an alternative treatment for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of percutaneous radiofrequency thermocoagulation for glossopharyngeal neuralgia

Wang

Tang²,

Zeng³

et al. 2016

Medicine

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“…The surgical procedure with the highest rate of success for patient with idiopathic GN is microvascular decompression. In a recent review, Rey-Dios and Cohen-Gadol22 reported the outcomes of 454 patients from 14 different series undergoing microvascular decompression of cranial nerves IX and X. The mean follow-up duration was 4.9 years.…”

Section: Discussionmentioning

confidence: 99%

Glossopharyngeal neuralgia associated with cardiac syncope

2016

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Glossopharyngeal neuralgia is a rare pain syndrome presenting with paroxysms of pain in the region of the glossopharyngeal nerve. Even more uncommon is the association between glossopharyngeal neuralgia and cardiac syncope. In these patients, the cardiovascular consequences may include bradycardia, hypotension and cardiac arrest. We describe the case of a 40-year-old patient who presented with this rare association of glossopharyngeal neuralgia and syncope. Multiple pauses including one lasting 14 s were noted on ambulatory ECG monitoring. In this case, the patient declined pharmacological treatment with carbamazepine or with permanent pacing and so far has been in remission from symptoms for 3 months.

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“…For treatment of GPN, the first option is microvascular decompression [9] , whereas for patients who refuse or cannot tolerate MVD operation, GKS is an alternative method. To date, there have been few reports about treating GPN with GKS [10][11][12][13][14][15][16] ( table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Gamma Knife Radiosurgery for Glossopharyngeal Neuralgia by Targeting the Medial Cisternal Segment of the Glossopharyngeal Nerve: Report of 3 Cases

Xiong

Tan²,

Fu³

et al. 2015

Stereotact Funct Neurosurg

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Gamma knife surgery (GKS) is now used as a treatment option for glossopharyngeal neuralgia (GPN). Most authors have selected the distal part of the nerve as the gamma knife target. Here we report on 3 patients with medically intractable GPN who were treated with GKS. All 3 patients had a single shot with a 4-mm collimator which was used to deliver 80 Gy to the 100% isodose line. The GKS targets were the medial cisternal segments of the glossopharyngeal nerve. Patients were investigated prospectively, treated, and then assessed periodically with respect to pain relief and neurological function. Three patients felt pain reduced at 2, 7, and 11 days, respectively. None of them have suffered recurrent pain since becoming pain free. The follow-up after radiosurgery was 25 months, 22 months, and 20 months, respectively. This preliminary experience provides encouraging evidence that choosing the medial cisternal segment of the glossopharyngeal nerve as the target is also an option for the treatment of GPN with stereotactic radiosurgery and is consistent with previous reports. Additional follow-ups and a larger number of patients are needed to demonstrate the long-term safety and effectiveness for this indication.

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

Cited by 87 publications

References 75 publications

Long-term outcomes of percutaneous radiofrequency thermocoagulation for glossopharyngeal neuralgia

Long-term outcomes of percutaneous radiofrequency thermocoagulation for glossopharyngeal neuralgia

Glossopharyngeal neuralgia associated with cardiac syncope

Gamma Knife Radiosurgery for Glossopharyngeal Neuralgia by Targeting the Medial Cisternal Segment of the Glossopharyngeal Nerve: Report of 3 Cases

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