Glossopharyngeal neuralgia is an uncommon cause of
facial pain with a relative frequency of 0.2 to 1.3% when compared with
trigeminal neuralgia. It is characterized by intermittent, lancinating
pain involving the posterior tongue and pharynx, often with radiation to deep ear structures. Since its first description in 1910 by Weisenburg, a variety of destructive procedures have been performed to provide relief in patients whose
pain was refractory to medical treatment. These procedures all necessitated the sacrifice of the glossopharyngeal nerve and, in most cases, also involved the destruction of at least part of the vagus nerve as well. In 1977, Laha and Jannetta reported good results in four patients who underwent
microvascular decompression of the glossopharyngeal and vagus nerves for
glossopharyngeal neuralgia. Since 1971, 40 patients have undergone
microvascular decompression of the glossopharyngeal and vagus nerves for treatment of typical
glossopharyngeal neuralgia. This procedure provided excellent immediate results (complete or > 95% relief of
pain) in 79%, with an additional 10% having a substantial (> 50%) reduction in
pain. Long-term follow-up (mean, 48 mo; range, 6-170 mo) reveals excellent results (complete or > 95% reduction in
pain without any medication) in 76% of the patients and substantial improvement in an additional 16%. There were two deaths at surgery (5%) both occurring early in the series as the result of hemodynamic lability causing
intracranial hemorrhage. Three patients (8%) suffered permanent 9th nerve
palsy. (ABSTRACT TRUNCATED AT 250 WORDS)