What Is Glossopharyngeal Neuralgia?
Glossopharyngeal Neuralgia is an irritation of the ninth cranial nerve causing extreme pain in the back of the throat, tongue and ear.
Attacks of intense, electric shock-like pain can occur without warning or be triggered by swallowing. Although the exact cause is not known, a blood vessel is often found compressing the nerve. It can also occur in people with throat or neck cancer. The condition is similar to Trigeminal Neuralgia of the face. Swallowing, chewing, talking, coughing, yawning or laughing can trigger an attack. Some people describe the feeling of a sharp object lodged in the throat.
Medications may initially relieve the pain, but surgery is often needed for long-term relief.
Our surgeons at Salus treat Glossopharyngeal Neuralgia I by performing the following surgical procedures:
MICROVASCULAR DECOMPRESSION (MVD)
MVD is a surgery to gently reroute the blood vessel from compressing the nerve by padding the artery with a sponge. Surgery is performed under general anesthesia and requires a 1 to 2 day hospital stay.
During surgery, a 1-inch opening, called a craniotomy, is made in the skull behind the ear. This exposes the nerve at its connection with the brainstem. A blood vessel (occasionally a tumor) is often found compressing the nerve (Fig. 2). After the nerve is freed from compression, it is protected with a small Teflon sponge (Fig. 3). The sponge remains in the brain permanently.
MVD provides pain relief in 85% of patients [1]. The major benefit of MVD is that it causes little or no swallowing or voice side effects. However, there is a 5% risk of death due to manipulation of the nearby vagus nerve, which can cause problems with heart rate and blood pressure.
MVD + NERVE RHIZOTOMY
MDV + NERVE RHIZOTOMY is a surgery to move the artery (if found) and cut the nerve root at its connection to the brainstem. Similar to the MVD surgery, a small opening is made in the back of the skull. If a blood vessel compressing the nerve is not found, or if it cannot be easily moved, the surgeon may opt to cut the nerve. The glossopharyngeal nerve is identified and cut. Then a stimulation probe is used to identify only the sensory roots of the vagus nerve. The sensory root fibers, which transmit the pain signals to the brain, are severed. The entire vagus nerve is not cut.