JOURNAL ARTICLE

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

Paolo Ferroli, Antonio Fioravanti, Marco Schiariti, Giovanni Tringali, Angelo Franzini, Fabio Calbucci, Giovanni Broggi
Acta Neurochirurgica 2009, 151 (10): 1245-50
19513582

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.

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