title: Stereotactic radiosurgery for glossopharyngeal neuralgia: preliminary report of 5 cases.
abstract: OBJECTIVE
  Glossopharyngeal neuralgia (GPN) is a rare pain disorder characterized by severe, stabbing pain of the ear, posterior tongue, and throat. The authors report their early experience of using stereotactic radiosurgery (SRS) as an alternative to posterior fossa surgery for patients with medically resistant GPN.
  
  
  METHODS
  Five patients (3 men, 2 woman) with medically resistant GPN underwent Gamma Knife surgery. The radiosurgical target was the distal portion of the glossopharyngeal and vagus nerves at the jugular foramen (glossopharyngeal meatus). The maximum radiation dose in all cases was 80 Gy. The median follow-up after radiosurgery was 13 months (range 2-19 months).
  
  
  RESULTS
  Three patients became pain-free at 2 days, 3 days, and 2 weeks, respectively, and were able to discontinue the medications taken preoperatively for their pain. None of these patients have suffered recurrent pain since becoming pain free. Two patients experienced no benefit from the procedure and underwent posterior fossa surgery 2 and 5 months after SRS. Both of these patients continued to have pain after posterior fossa surgery. One of these patients was later discovered to have a head and neck cancer as the cause of his pain. No patient developed hoarseness or dysphagia after radiosurgery.
  
  
  CONCLUSIONS
  This preliminary experience demonstrates that SRS is an option for patients with medically resistant GPN. Additional follow-up and a larger number of patients are needed to demonstrate the long-term safety and optimal radiation dosimetry for this indication.
authors: Departments of Neurological Surgery, Mayo Clinic College ofMedicine, Rochester, Minnesota 55905, USA. pollock.bruce@mayo.edu
authors: Bruce E
authors: BE
authors: Pollock
authors: Christopher J
authors: CJ
authors: Boes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D020435:Glossopharyngeal Nerve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000295:instrumentation*; D016896:Treatment Outcome