title: Microvascular decompression for glossopharyngeal neuralgia: a long-term retrospectic review of the Milan-Bologna experience in 31 consecutive cases.
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.
authors.affiliation: Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy. ferrolipaolo@hotmail.com
authors.forename: Paolo
authors.initials: P
authors.lastname: Ferroli
authors.forename: Antonio
authors.initials: A
authors.lastname: Fioravanti
authors.forename: Marco
authors.initials: M
authors.lastname: Schiariti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tringali
authors.forename: Angelo
authors.initials: A
authors.lastname: Franzini
authors.forename: Fabio
authors.initials: F
authors.lastname: Calbucci
authors.forename: Giovanni
authors.initials: G
authors.lastname: Broggi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003388:Cranial Fossa, Posterior / Q000033:anatomy & histology / Q000601:surgery; D003399:Craniotomy / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D019299:Decompression, Surgical / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D005260:Female; D005930:Glossopharyngeal Nerve / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D020435:Glossopharyngeal Nerve Diseases / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007558:Italy; D008297:Male; D008416:Mastoid / Q000033:anatomy & histology / Q000601:surgery; D008526:Medulla Oblongata / Q000098:blood supply / Q000503:physiopathology / Q000601:surgery; D008866:Microsurgery / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000401:mortality; D010148:Intractable Pain / Q000453:epidemiology / Q000601:surgery; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control; D012008:Recurrence; D012189:Retrospective Studies; D013995:Time; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D014711:Vertebral Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery