[Idiopathic neuralgia of the glossopharyngeal nerve. Study of a series of 14 cases and review of the literature].
The authors report 14 cases of idiopathic glossopharyngeal neuralgias surgically treated and followed over a mean 3.5 year period. The series consisted of 7 females and 7 males, 66 years old on average. The pain was located on the left side in 13 out of the 14 cases. A trigeminal neuralgia was associated to the glossopharyngeal pain (on the same side) in 4 cases. The vertebral angiogram evidenced a megadolicho-artery in 6 cases and was considered normal in 8 cases. The surgical treatment was a percutaneous thermocoagulation of the Andersh ganglion in 3 case (the thermolesion could not be completed in one of these cases due to the onset of coronarian ischemia). A microsurgical vascular decompression was carried out 9 times, alone in 8 cases, associated with a radicotomy in one case. A mere radicotomy was performed in 2 other cases, because of no finding vascular compression. Total pain relief was achieved in the 2 cases of completed thermocoagulation and in all the 11 cases of direct approach. The thermocoagulations, as well as the radicotomies, of the IX and anterior rootlets of the X produced in each case permanent deficits in the IX and X territories, whilst the side-effects of the decompression procedure were only mild or transient. Therefore microsurgical vascular decompression is preferred by the authors everytime the age, general conditions and the patient's acceptance authorize it.
Sindou
M
M
Service de Neurochirurgie A, Hôpital et Neurochirurgical Pierre Wertheimer, Lyon.
Henry
J F
JF
Blanchard
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001488:Basilar Artery / Q000002:abnormalities; D002533:Cerebral Angiography; D004564:Electrocoagulation; D005260:Female; D005930:Glossopharyngeal Nerve; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology / Q000601:surgery*