The Vagus Nerve in Surgical Consideration of Glossopharyngeal Neuralgia

Abstract

G LOSSOPHARYNGEAL neuralgia is a syndrome of tic-like pain at the angle of the jaw, with radiation frequently appearing at the external audi tory canal. I t may be confused with trigeminal neuralgia 1,3 of the 3rd division of the 5th cranial nerve and with neuralgia of the superior laryngeal nerve. Cocainization of the tonsillar area ordinarily serves to relieve and thus diagnose glossopharyngeal neuralgia, and cocainization of the pyriform fossa of the larynx is said to relieve neuralgia of the superior laryngeal nerve. 2 Because of the anatomic and physiologic association of the 9th and 10th cranial nerves, it would not be surprising to find clinical association of the two in neuralgia at the angle of the jaw, but to our knowledge, this has not been reported. I t is the purpose of this paper to report involvement of the vagus nerve in so-called glossopharyngeal neuralgia, and to report an improved method of diagnosis tha t we believe essential to the recognition of the unusual case where both the 9th and 10th nerves are involved in neuralgia and so to take appropriate surgical measures for relief.