Microvascular decompression for glossopharyngeal neuralgia: a long-term retrospectic review of the Milan-Bologna experience in 31 consecutive cases

Acta Neurochir (Wien). 2009 Oct;151(10):1245-50. doi: 10.1007/s00701-009-0330-5. Epub 2009 Jun 10.

Abstract

Objective: To examine surgical findings and results of microvascular decompression (MVD) for glossopharyngeal neuralgia (GN).

Methods: Between 1990 and 2007, 31 consecutive patients affected by drug-resistant GN underwent MVD through a retromastoid keyhole in the supine position with the head rotated to the opposite side. A retrospective analysis was performed that paid particular attention to the relationship among surgical technique, pain control and side effects.

Results: A vascular compression of the glossopharyngeal nerve was found in all cases. Twenty-eight out of 31 patients (90.3%) were found to be pain free without medication at long-term follow-up (1-17 years, mean 7.5 years). Three patients (9.7%) were found to require medication to control pain paroxysms that were less frequent and less severe than those observed preoperatively. Two patients required repeated surgery for a drug-resistant recurrence of pain for a total of 33 MVDs. We observed no mortality and did not find any long-term surgical morbidity. Cranial nerve impairment, when observed, always resolved in the following months.

Conclusions: MVD is a safe and effective treatment for GN in patients of all ages.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cranial Fossa, Posterior / anatomy & histology
  • Cranial Fossa, Posterior / surgery
  • Craniotomy / methods
  • Craniotomy / mortality
  • Craniotomy / statistics & numerical data
  • Decompression, Surgical / methods*
  • Decompression, Surgical / mortality
  • Decompression, Surgical / statistics & numerical data
  • Female
  • Glossopharyngeal Nerve / pathology
  • Glossopharyngeal Nerve / physiopathology*
  • Glossopharyngeal Nerve / surgery*
  • Glossopharyngeal Nerve Diseases / pathology
  • Glossopharyngeal Nerve Diseases / physiopathology*
  • Glossopharyngeal Nerve Diseases / surgery*
  • Humans
  • Italy
  • Male
  • Mastoid / anatomy & histology
  • Mastoid / surgery
  • Medulla Oblongata / blood supply
  • Medulla Oblongata / physiopathology
  • Medulla Oblongata / surgery
  • Microsurgery / methods
  • Microsurgery / mortality
  • Microsurgery / statistics & numerical data
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Minimally Invasive Surgical Procedures / mortality
  • Pain, Intractable / epidemiology
  • Pain, Intractable / surgery
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / prevention & control
  • Recurrence
  • Retrospective Studies
  • Time
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures / methods*
  • Vascular Surgical Procedures / mortality
  • Vascular Surgical Procedures / statistics & numerical data
  • Vertebral Artery / pathology
  • Vertebral Artery / physiopathology
  • Vertebral Artery / surgery