Microvascular decompression for glossopharyngeal neuralgia: a long-term retrospectic review of the Milan-Bologna experience in 31 consecutive cases.
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.
Ferroli
Paolo
P
Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy. ferrolipaolo@hotmail.com
Fioravanti
Antonio
A
Schiariti
Marco
M
Tringali
Giovanni
G
Franzini
Angelo
A
Calbucci
Fabio
F
Broggi
Giovanni
G
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