Skip to main content
SpringerLink
Log in

Salvage gamma knife surgery for recurrent glossopharyngeal neuralgia following microvascular decompression: a retrospective case series

  • Original Article - Functional Neurosurgery - Pain
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Although microvascular decompression (MVD) is recognized as the preferred therapy for drug-resistant idiopathic glossopharyngeal neuralgia (GPN), the management of recurrent GPN following MVD is seldom mentioned in the current literature. This study aims to demonstrate the efficacy and safety of salvage Gamma Knife surgery (GKS) in the treatment of recurrent GPN after MVD.

Methods

From October 2012 to January 2018, seven patients (three males and four females) underwent salvage GKS for recurrent GPN following MVD, including two patients who received repeat GKS due to pain recurrence after their initial GKS salvage. The median age was 69 years (range 49–81 years) at first GKS and 72 years (67 years; 77 years) at second GKS. The delivered dose was 80 or 90 Gy at first GKS and 90 Gy at second GKS. Pain outcome was assessed according to the Barrow Neurological Institute (BNI) score.

Results

The median duration of follow-up after first GKS was 68 months (range 29–89 months) and 45 months (56 months; 33 months) after second GKS. The median time to pain response was 24 days (range, 6–80 days). One patient experienced palatoglossal hyperesthesia after first GKS, and no complications were noted after second GKS. At the last follow-up, 4 patients were BNI I, 1 was BNI II, and 2 was BNI IIIa.

Conclusions

Salvage GKS is safe and effective for treating recurrent GPN after MVD, even for patients who experienced pain recurrence following their initial GKS salvage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Borius PY, Tuleasca C, Muraciole X, Negretti L, Schiappacasse L, Dorenlot A, Marguet M, Zeverino M, Donnet A, Levivier M, Regis J (2018) Gamma Knife radiosurgery for glossopharyngeal neuralgia: a study of 21 patients with long-term follow-up. Cephalalgia 38:543–550. https://doi.org/10.1177/0333102417698961

    Article  PubMed  Google Scholar 

  2. Chen J, Sindou M (2015) Vago-glossopharyngeal neuralgia: a literature review of neurosurgical experience. Acta Neurochir 157:311–321; discussion 321. https://doi.org/10.1007/s00701-014-2302-7

    Article  PubMed  Google Scholar 

  3. Franzini A, Messina G, Franzini A, Marchetti M, Ferroli P, Fariselli L, Broggi G (2017) Treatments of glossopharyngeal neuralgia: towards standard procedures. Neurol Sci 38:51–55. https://doi.org/10.1007/s10072-017-2909-6

    Article  PubMed  Google Scholar 

  4. Headache Classification Subcommittee of the International Headache S (2004) The International Classification of Headache Disorders: 2nd edition. Cephalalgia 24(Suppl 1):9–160. https://doi.org/10.1111/j.1468-2982.2003.00824.x

    Article  Google Scholar 

  5. Ikeda N, Toda H, Yamamoto M, Kanemaru S, Ishikawa M, Iwasaki K (2015) A perforating artery compressing the nerve rootlet and causing glossopharyngeal neuralgia. Neurosurgery 11(Suppl 3):382–386. https://doi.org/10.1227/NEU.0000000000000855

    Article  PubMed  Google Scholar 

  6. Kano H, Urgosik D, Liscak R, Pollock BE, Cohen-Inbar O, Sheehan JP, Sharma M, Silva D, Barnett GH, Mathieu D, Sisterson ND, Lunsford LD (2016) Stereotactic radiosurgery for idiopathic glossopharyngeal neuralgia: an international multicenter study. J Neurosurg 125:147–153. https://doi.org/10.3171/2016.7.GKS161523

    Article  PubMed  Google Scholar 

  7. Kim MK, Park JS, Ahn YH (2017) Microvascular decompression for glossopharyngeal neuralgia: clinical analyses of 30 cases. J Korean Neurosurg Soc 60:738–748. https://doi.org/10.3340/jkns.2017.0506.010

    Article  PubMed  PubMed Central  Google Scholar 

  8. Laha RK, Jannetta PJ (1977) Glossopharyngeal neuralgia. J Neurosurg 47:316–320. https://doi.org/10.3171/jns.1977.47.3.0316

    Article  CAS  PubMed  Google Scholar 

  9. Lu VM, Goyal A, Graffeo CS, Perry A, Jonker BP, Link MJ (2018) Glossopharyngeal neuralgia treatment outcomes after nerve section, microvascular decompression, or stereotactic radiosurgery: a systematic review and meta-analysis. World Neurosurg 120(572-582):e577. https://doi.org/10.1016/j.wneu.2018.09.042

    Article  Google Scholar 

  10. Martinez-Alvarez R, Martinez-Moreno N, Kusak ME, Rey-Portoles G (2014) Glossopharyngeal neuralgia and radiosurgery. J Neurosurg 121(Suppl):222–225. https://doi.org/10.3171/2014.8.GKS141273

    Article  PubMed  Google Scholar 

  11. Ni B, Hu Y, Du T, Zhang X, Zhu H (2020) Reoperation after failed microvascular decompression for glossopharyngeal neuralgia. Acta Neurochir. https://doi.org/10.1007/s00701-020-04383-w

  12. Palanisamy D, Kyosuke M, Yasuhiro Y, Tsukasa K, Kato Y (2018) Management of recurrent glossopharyngeal neuralgia following microvascular decompression surgery. World Neurosurg 117:339–343. https://doi.org/10.1016/j.wneu.2018.06.136

    Article  PubMed  Google Scholar 

  13. Patel A, Kassam A, Horowitz M, Chang YF (2002) Microvascular decompression in the management of glossopharyngeal neuralgia: analysis of 217 cases. Neurosurgery 50:705–710 discussion 710-701

    Article  Google Scholar 

  14. Pommier B, Touzet G, Lucas C, Vermandel M, Blond S, Reyns N (2018) Glossopharyngeal neuralgia treated by Gamma Knife radiosurgery: safety and efficacy through long-term follow-up. J Neurosurg 128:1372–1379. https://doi.org/10.3171/2017.3.JNS162542

    Article  PubMed  Google Scholar 

  15. Rey-Dios R, Cohen-Gadol AA (2013) Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery. Neurosurg Focus 34:E8. https://doi.org/10.3171/2012.12.FOCUS12391

    Article  PubMed  Google Scholar 

  16. Rushton JG, Stevens JC, Miller RH (1981) Glossopharyngeal (vagoglossopharyngeal) neuralgia: a study of 217 cases. Arch Neurol 38:201–205. https://doi.org/10.1001/archneur.1981.00510040027002

    Article  CAS  PubMed  Google Scholar 

  17. Spina A, Boari N, Gagliardi F, Bailo M, Morselli C, Iannaccone S, Mortini P (2019) The emerging role of gamma knife radiosurgery in the management of glossopharyngeal neuralgia. Neurosurg Rev 42:31–38. https://doi.org/10.1007/s10143-017-0886-0

    Article  PubMed  Google Scholar 

  18. Stanic S, Franklin SD, Pappas CT, Stern RL (2012) Gamma knife radiosurgery for recurrent glossopharyngeal neuralgia after microvascular decompression. Stereotact Funct Neurosurg 90:188–191. https://doi.org/10.1159/000338089

    Article  PubMed  Google Scholar 

  19. Taha JM, Tew JM Jr (1995) Long-term results of surgical treatment of idiopathic neuralgias of the glossopharyngeal and vagal nerves. Neurosurgery 36:926–930 discussion 930-921

    Article  CAS  Google Scholar 

  20. Teton ZE, Holste KG, Hardaway FA, Burchiel KJ, Raslan AM (2019) Pain-free survival after vagoglossopharyngeal complex sectioning with or without microvascular decompression in glossopharyngeal neuralgia. J Neurosurg 132:232–238. https://doi.org/10.3171/2018.8.JNS18239

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  22. Xiong NX, Tan D, Fu P, Zhao HY (2015) Gamma Knife radiosurgery for glossopharyngeal neuralgia by targeting the medial cisternal segment of the glossopharyngeal nerve: report of 3 cases. Stereotact Funct Neurosurg 93:292–296. https://doi.org/10.1159/000375176

    Article  PubMed  Google Scholar 

  23. Xiong NX, Zhao HY, Zhang FC, Liu RE (2012) Vagoglossopharyngeal neuralgia treated by microvascular decompression and glossopharyngeal rhizotomy: clinical results of 21 cases. Stereotact Funct Neurosurg 90:45–50. https://doi.org/10.1159/000333828

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Songshan Chai and Hao Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Songshan Chai, Hao Xu, Dongdong Xiao, Jiajing Wang, Yihao Wang, Junjun Li & Peng Fu

  2. Department of Neurosurgery, General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China

    Hao Xu

  3. Department of International Education, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Hendrik Pool

  4. Department of Neurosurgery, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuhan, 430071, Hubei, China

    Nanxiang Xiong

Authors
  1. Songshan Chai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hao Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dongdong Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiajing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yihao Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Junjun Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Peng Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hendrik Pool
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nanxiang Xiong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nanxiang Xiong.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The requirement for informed consent was waived owing to its retrospective design.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Functional Neurosurgery - Pain

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chai, S., Xu, H., Xiao, D. et al. Salvage gamma knife surgery for recurrent glossopharyngeal neuralgia following microvascular decompression: a retrospective case series. Acta Neurochir 163, 1021–1026 (2021). https://doi.org/10.1007/s00701-020-04654-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-020-04654-6

Keywords

Search

Navigation