Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Glossopharyngeal Neuralgia

  • Jae Sung, Park (Department of Neurosurgery, Konyang University College of Medicine) ;
  • Young Hwan, Ahn (Department of Neurosurgery, Ajou University School of Medicine)
  • Received : 2022.07.21
  • Accepted : 2022.12.02
  • Published : 2023.01.01
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Abstract

Glossopharyngeal neuralgia (GPN) is a rare disease that must be differentiated from trigeminal neuralgia. The purpose of this article is to provide a comprehensive review of anatomy, pathophysiology, diagnostic criteria, and several options of treatment for GPN. Lessons learned through our experience of treating GPN are presented in detail, as well as cases of misdiagnosis and diagnostic pitfalls. Microvascular decompression (MVD) should be primarily considered for medically intractable GPN. Techniques employed in MVD for GPN are categorized and described. Especially, we underscore the advantages of the 'transposition' technique where insulating material is positioned 'off' the root entry zone (REZ), instead of 'on' it. We believe this 'off-the-REZ' technique can fundamentally prevent recurrence, if applicable. In addition, Gamma Knife radiosurgery can be an alternative option when a patient is ineligible for MVD, though it is categorized as a destructive procedure.

Keywords

References

  1. Ajayi NO, Lazarus L, Satyapal KS : Trigeminal cave and ganglion: an anatomical review. Int J Morphol 31 : 1444-1448, 2013  https://doi.org/10.4067/S0717-95022013000400047
  2. Barbash GI, Keren G, Korczyn AD, Sharpless NS, Chayen M, Copperman Y, et al. : Mechanisms of syncope in glossopharyngeal neuralgia. Electroencephalogr Clin Neurophysiol 63 : 231-235, 1986  https://doi.org/10.1016/0013-4694(86)90089-1
  3. Blumenfeld A, Nikolskaya G : Glossopharyngeal neuralgia. Curr Pain Headache Rep 17 : 343, 2013  https://doi.org/10.1007/s11916-013-0343-x
  4. Bohm E, Strang RR : Glossopharyngeal neuralgia. Brain 85 : 371-388, 1962  https://doi.org/10.1093/brain/85.2.371
  5. Borius PY, Tuleasca C, Muraciole X, Negretti L, Schiappacasse L, Dorenlot A, et al. : Gamma Knife radiosurgery for glossopharyngeal neuralgia: a study of 21 patients with long-term follow-up. Cephalalgia 38 : 543-550, 2018  https://doi.org/10.1177/0333102417698961
  6. Breeze R, Ignelzi RJ : Microvascular decompression for trigeminal neuralgia. Results with special reference to the late recurrence rate. J Neurosurg 57 : 487-490, 1982  https://doi.org/10.3171/jns.1982.57.4.0487
  7. Chen J, Sindou M : Vago-glossopharyngeal neuralgia: a literature review of neurosurgical experience. Acta Neurochir (Wien) 157 : 311-321, 2015  https://doi.org/10.1007/s00701-014-2302-7
  8. Dandy WE : Glossopharyngeal neuralgia (tic douloureux): its diagnosis and treatment. Arch Surg 15 : 198-214, 1927  https://doi.org/10.1001/archsurg.1927.01130200046002
  9. Fromm GH : Clinical pharmacology of drugs used to treat head and face pain. Neurol Clin 8 : 143-151, 1990  https://doi.org/10.1016/s0733-8619(18)30377-3
  10. Giorgi C, Broggi G : Surgical treatment of glossopharyngeal neuralgia and pain from cancer of the nasopharynx. A 20-year experience. J Neurosurg 61 : 952-955, 1984  https://doi.org/10.3171/jns.1984.61.5.0952
  11. Hardy DG, Rhoton AL Jr : Microsurgical relationships of the superior cerebellar artery and the trigeminal nerve. J Neurosurg 49 : 669-678, 1978  https://doi.org/10.3171/jns.1978.49.5.0669
  12. Harris W : Persistent pain in lesions of the peripheral and central nervous system. Br Med J 2 : 896-900, 1921  https://doi.org/10.1136/bmj.2.4790.896
  13. Janetta PJ : Microsurgical exploration and decompression of the facial nerve in hemifacial spasm. Curr Top Surg Res 2 : 217-220, 1970 
  14. Kakizawa Y, Seguchi T, Kodama K, Ogiwara T, Sasaki T, Goto T, et al. : Anatomical study of the trigeminal and facial cranial nerves with the aid of 3.0-tesla magnetic resonance imaging. J Neurosurg 108 : 483-490, 2008  https://doi.org/10.3171/JNS/2008/108/3/0483
  15. Kano H, Urgosik D, Liscak R, Pollock BE, Cohen-Inbar O, Sheehan JP, et al. : Stereotactic radiosurgery for idiopathic glossopharyngeal neuralgia: an international multicenter study. J Neurosurg 125(Suppl 1) : 147-153, 2016  https://doi.org/10.3171/2016.7.GKS161523
  16. Kim MK, Park JS, Ahn YH : Microvascular decompression for glossopharyngeal neuralgia: clinical analyses of 30 cases. J Korean Neurosurg Soc 60 : 738-748, 2017  https://doi.org/10.3340/jkns.2017.0506.010
  17. Kong Y, Heyman A, Entman ML, Mcintosh HD : Glossopharyngeal neuralgia associated with bradycardia, syncope, and seizures. Circulation 30 : 109-113, 1964  https://doi.org/10.1161/01.CIR.30.1.109
  18. Koratkar H, Parashar V, Koratkar S : A review of neuropathic pain conditions affecting teeth. Gen Dent 58 : 436-441; quiz 442-443, 2010 
  19. Kruger MT, Dong CCJ, Honey CR : Defining the anatomy of the vagus nerve and its clinical relevance for the neurosurgical treatment of glossopharyngeal neuralgia. Stereotact Funct Neurosurg 97 : 244-248, 2019  https://doi.org/10.1159/000504263
  20. Laha RK, Jannetta PJ : Glossopharyngeal neuralgia. J Neurosurg 47 : 316-320, 1977  https://doi.org/10.3171/jns.1977.47.3.0316
  21. Lazorthes Y, Verdie JC : Radiofrequency coagulation of the petrous ganglion in glossopharyngeal neuralgia. Neurosurgery 4 : 512-516, 1979  https://doi.org/10.1227/00006123-197906000-00003
  22. Lee SH, Park JS, Ahn YH : Bioglue-coated Teflon sling technique in microvascular decompression for hemifacial spasm involving the vertebral artery. J Korean Neurosurg Soc 59 : 505-511, 2016  https://doi.org/10.3340/jkns.2016.59.5.505
  23. Linskey ME, Ratanatharathorn V, Penagaricano J : A prospective cohort study of microvascular decompression and Gamma Knife surgery in patients with trigeminal neuralgia. J Neurosurg 109 Suppl : 160-172, 2008  https://doi.org/10.3171/JNS/2008/109/12/S25
  24. Ma Y, Li YF, Wang QC, Wang B, Huang HT : Neurosurgical treatment of glossopharyngeal neuralgia: analysis of 103 cases. J Neurosurg 124 : 1088-1092, 2016  https://doi.org/10.3171/2015.3.jns141806
  25. Manzoni GC, Torelli P : Epidemiology of typical and atypical craniofacial neuralgias. Neurol Sci 26 Suppl : s65-s67, 2005  https://doi.org/10.1007/s10072-005-0410-0
  26. Matsushima T, Huynh-Le P, Miyazono M : Trigeminal neuralgia caused by venous compression. Neurosurgery 55 : 334-337; discussion 338-339, 2004  https://doi.org/10.1227/01.NEU.0000129552.87291.87
  27. Moretti R, Torre P, Antonello RM, Bava A, Cazzato G : Gabapentin treatment of glossopharyngeal neuralgia: a follow-up of four years of a single case. Eur J Pain 6 : 403-407, 2002  https://doi.org/10.1016/S1090-3801(02)00026-5
  28. Nishihara K, Hanakita J, Kinuta Y, Kondo A, Yamamoto Y, Kishimoto S : Three cases of Eagle's syndrome. No Shinkei Geka 14(3 Suppl) : 441-445, 1986 
  29. Oishi M, Fukuda M, Noto Y, Kawaguchi T, Hiraishi T, Fujii Y : Trigeminal neuralgia associated with the specific bridging pattern of transverse pontine vein: diagnostic value of three-dimensional multifusion volumetric imaging. Stereotact Funct Neurosurg 89 : 226-233, 2011  https://doi.org/10.1159/000326778
  30. Park JS, Lee S, Park SK, Lee JA, Park K : Facial motor evoked potential with paired transcranial magnetic stimulation: prognostic value following microvascular decompression for hemifacial spasm. J Neurosurg 131 : 1780-1787, 2018  https://doi.org/10.3171/2018.8.jns18708
  31. Patel A, Kassam A, Horowitz M, Chang YF : Microvascular decompression in the management of glossopharyngeal neuralgia: analysis of 217 cases. Neurosurgery 50 : 705-710; discussion 710-711, 2002  https://doi.org/10.1097/00006123-200204000-00004
  32. Pearce JM : Glossopharyngeal neuralgia. Eur Neurol 55 : 49-52, 2006  https://doi.org/10.1159/000091429
  33. Peris-Celda M, Oushy S, Perry A, Graffeo CS, Carlstrom LP, Zimmerman RS, et al. : Nervus intermedius and the surgical management of geniculate neuralgia. J Neurosurg 131 : 343-351, 2018  https://doi.org/10.3171/2018.3.jns172920
  34. Rey-Dios R, Cohen-Gadol AA : Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery. Neurosurg Focus 34 : E8, 2013  https://doi.org/10.3171/2012.12.FOCUS12391
  35. Rozen TD : Trigeminal neuralgia and glossopharyngeal neuralgia. Neurol Clin 22 : 185-206, 2004  https://doi.org/10.1016/S0733-8619(03)00094-X
  36. Rushton JG, Stevens JC, Miller RH : Glossopharyngeal (vagoglossopharyngeal) neuralgia: a study of 217 cases. Arch Neurol 38 : 201-205, 1981  https://doi.org/10.1001/archneur.1981.00510040027002
  37. Sampson JH, Grossi PM, Asaoka K, Fukushima T : Microvascular decompression for glossopharyngeal neuralgia: long-term effectiveness and complication avoidance. Neurosurgery 54 : 884-890; discussion 889-890, 2004  https://doi.org/10.1227/01.NEU.0000114142.98655.CC
  38. Sarlani E, Grace EG, Balciunas BA, Schwartz AH : Trigeminal neuralgia in a patient with multiple sclerosis and chronic inflammatory demyelinating polyneuropathy. J Am Dent Assoc 136 : 469-476, 2005  https://doi.org/10.14219/jada.archive.2005.0202
  39. Scholz J, Finnerup NB, Attal N, Aziz Q, Baron R, Bennett MI, et al. : The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain 160 : 53-59, 2019  https://doi.org/10.1097/j.pain.0000000000001365
  40. Sibilla L, Agarwal N : Cranial Nerve IX: Glossopharyngeal in Agarwal N, Port J (eds) : Neuroimaging: Anatomy Meets Function. London : Springer, 2018, pp207-210 
  41. Sindou M, Henry JF, Blanchard P : Idiopathic neuralgia of the glossopharyngeal nerve. Study of a series of 14 cases and review of the literature. Neurochirurgie 37 : 18-25, 1991 
  42. Singh PM, Kaur M, Trikha A : An uncommonly common: glossopharyngeal neuralgia. Ann Indian Acad Neurol 16 : 1-8, 2013  https://doi.org/10.4103/0972-2327.107662
  43. Singleton AO : Glossopharyngeal neuralgia and its surgical relief. Ann Surg 83 : 338-344, 1926  https://doi.org/10.1097/00000658-192603000-00004
  44. Stanic S, Franklin SD, Pappas CT, Stern RL : Gamma knife radiosurgery for recurrent glossopharyngeal neuralgia after microvascular decompression. Stereotact Funct Neurosurg 90 : 188-191, 2012  https://doi.org/10.1159/000338089
  45. Stieber VW, Bourland JD, Ellis TL : Glossopharyngeal neuralgia treated with gamma knife surgery: treatment outcome and failure analysis. Case report. J Neurosurg 102 Suppl : 155-157, 2005  https://doi.org/10.3171/jns.2005.102.s_supplement.0155
  46. Tew Jr J, Taha J : Percutaneous rhizotomy in the treatment of intractable facial pain (trigeminal, glossopharyngeal, and vagal nerves) in Schmidek HH, Sweet WH (eds) : Operative Neurosurgical Techniques: Indications, Methods, and Results. Philadelphia : WB Saunders Co, 1995, pp1469-1484 
  47. Tubbs RS, Shoja MM, Loukas M : Anatomy of the glossopharyngeal nerve in Tubbs RS, Rizk E, Shoja MM, Loukas M, Barbaro N, Spinner RJ (eds) : Nerves and Nerve Injuries. Cambridge : Academic Press, 2015, pp371-383 
  48. Wang C, Kundaria S, Fernandez-Miranda J, Duvvuri U : A description of the anatomy of the glossopharyngeal nerve as encountered in transoral surgery. Laryngoscope 126 : 2010-2015, 2016  https://doi.org/10.1002/lary.25706
  49. Wang M, Chae R, Shehata J, Vigo V, Raygor KP, Tomasi SO, et al. : Comparative analysis of surgical exposure and freedom between the subtonsillar, endoscope-assisted subtonsillar, and far-lateral approaches to the lower clivus: a cadaveric study. J Clin Neurosci 72 : 412-419, 2020  https://doi.org/10.1016/j.jocn.2019.11.015
  50. White JC, Sweet WH : Pain and the neurosurgeon: a forty-year experience. Springfield : CC Thomas, 1969 
  51. Wiffen PJ, Derry S, Moore RA, McQuay HJ : Carbamazepine for acute and chronic pain in adults. Cochrane Database Syst Rev (1) : CD005451, 2011 
  52. Williams BJ, Schlesinger D, Sheehan J : Glossopharyngeal neuralgia treated with gamma knife radiosurgery. World Neurosurg 73 : 413-417, 2010  https://doi.org/10.1016/j.wneu.2010.01.007
  53. Yang KH, Na JH, Kong DS, Park K : Combined hyperactive dysfunction syndrome of the cranial nerves. J Korean Neurosurg Soc 46 : 351-354, 2009  https://doi.org/10.3340/jkns.2009.46.4.351
  54. Yomo S, Arkha Y, Donnet A, Regis J : Gamma knife surgery for glossopharyngeal neuralgia. J Neurosurg 110 : 559-563, 2009  https://doi.org/10.3171/2008.8.17641
  55. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 38 : 1-211, 2018 https://doi.org/10.1177/0333102417738202