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Microvascular decompression for glossopharyngeal neuralgia: a retrospective analysis of 228 cases

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Abstract

Background

Glossopharyngeal neuralgia (GPN) is an uncommon craniofacial pain syndrome caused by neurovascular conflict. Compared to trigeminal neuralgia or hemifacial spasm, the incidence of GPN was very low. Until now, little is known about the long-term outcome following microvascular decompression (MVD) process.

Methods

Between 2006 and 2016, 228 idiopathic GPN patients underwent MVD in our department. Those cases were retrospectively reviewed with emphasis on intraoperative findings and long-term postoperative outcomes. The average period of follow-up was 54.3 ± 6.2 months.

Results

Intraoperatively, the culprit was identified as the posterior inferior cerebellar artery (PICA) in 165 cases (72.3%), the vertebral artery (VA) in 14 (6.1%), vein in 10 (4.4%), and a combination of multiple arteries or venous offending vessels in 39 (17.2%). The immediately postoperative outcome was excellent in 204 cases (89.5%), good in 12 (5.3%), fair in 6 (2.6%) and poor in 6 (2.6%). More than 5-year follow-up was obtained in 107 cases (46.9%), which presented as excellent in 93 (86.9%), good in 6 (5.6%), fair in 3 (2.8%) and poor in 5 (4.7%). Thirty-seven (16.2%) of the patients experienced some postoperative neurological deficits immediately, such as dysphagia, hoarseness and facial paralysis, which has been improved at the last follow-up in most cases, except 2.

Conclusions

This investigation demonstrated that MVD is a safe and effective remedy for treatment of GPN.

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Acknowledgements

Our thanks to Dr. Yong-Sheng Li for collection and analysis of the clinical data.

Funding

The government of China provided financial support in the form of National Natural Science Foundation (no. 81471317) funding. The sponsor had no role in the design or conduct of this research.

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Author notes

  1. Lei Xia and Yong-sheng Li contribute equally for this article.

Authors and Affiliations

  1. Department of Neurosurgery, XinHua Hospital (The Cranial Nerve Disease Center of Shanghai), Shanghai JiaoTong University School of Medicine, 1665 KongJiang Rd, Shanghai, 200092, China

    Lei Xia, Ming-Xing Liu, Jun Zhong, Ning-Ning Dou, Bin Li & Shi-Ting Li

  2. Department of General Surgery, XinHua Hospital, Shanghai JiaoTong University School of Medicine, 1665 KongJiang Rd, Shanghai, 200092, China

    Yong-Sheng Li

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  1. Lei Xia
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Correspondence to Jun Zhong.

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Xia, L., Li, YS., Liu, MX. et al. Microvascular decompression for glossopharyngeal neuralgia: a retrospective analysis of 228 cases. Acta Neurochir 160, 117–123 (2018). https://doi.org/10.1007/s00701-017-3347-1

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