Microvascular decompression for glossopharyngeal neuralgia: long-term effectiveness and complication avoidance.
OBJECTIVE
To establish the long-term safety, efficacy, and durability of microvascular decompression (MVD) for the treatment of glossopharyngeal neuralgia, this study presents the immediate (<6 mo) postoperative and long-term results of a large series of 47 patients with treated with MVD.


METHODS
Operative reports and hospital charts were analyzed to collect demographic information, clinical presentation, and surgical findings. Surgical results and complications were ascertained by direct patient contact or by contact with the patient's family or physician if the patient was dead. Long-term (>10 yr) personal follow-up was available for 29 of 47 patients.


RESULTS
Forty-six (98%) of 47 patients experienced complete relief of pain immediately after MVD. Long-term follow-up was available for 29 of these 47 patients (range, 125-211 mo; median, 152 mo, or 12.7 yr), and 28 of these 29 patients continued to be pain-free. Permanent neurological deficits (>6 mo) attributed to the surgery were observed in 5 (11%) of 47 patients. Of these patients, 4 of 5 had mild hoarseness or dysphagia or both, and one had a Grade II/VI facial nerve paresis.


CONCLUSIONS
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.
Sampson
John H
JH
Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Box 3807, Durham, NC 27710, USA. john.sampson@duke.edu
Grossi
Peter M
PM
Asaoka
Katsuyuki
K
Fukushima
Takanori
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy / Q000295:instrumentation; D019299:Decompression, Surgical / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D020435:Glossopharyngeal Nerve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000601:surgery*; D008866:Microsurgery / Q000295:instrumentation*; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome