[Idiopathic neuralgia of the glossopharyngeal nerve. Study of a series of 14 cases and review of the literature].

Abstract

The authors report 14 cases of idiopathic glossopharyngeal neuralgias surgically treated and followed over a mean 3.5 year period. The series consisted of 7 females and 7 males, 66 years old on average. The pain was located on the left side in 13 out of the 14 cases. A trigeminal neuralgia was associated to the glossopharyngeal pain (on the same side) in 4 cases. The vertebral angiogram evidenced a megadolicho-artery in 6 cases and was considered normal in 8 cases. The surgical treatment was a percutaneous thermocoagulation of the Andersh ganglion in 3 case (the thermolesion could not be completed in one of these cases due to the onset of coronarian ischemia). A microsurgical vascular decompression was carried out 9 times, alone in 8 cases, associated with a radicotomy in one case. A mere radicotomy was performed in 2 other cases, because of no finding vascular compression. Total pain relief was achieved in the 2 cases of completed thermocoagulation and in all the 11 cases of direct approach. The thermocoagulations, as well as the radicotomies, of the IX and anterior rootlets of the X produced in each case permanent deficits in the IX and X territories, whilst the side-effects of the decompression procedure were only mild or transient. Therefore microsurgical vascular decompression is preferred by the authors everytime the age, general conditions and the patient's acceptance authorize it.