Glossopharyngeal Nerve Block

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Abstract

The glossopharyngeal nerve (cranial nerve IX) is an important consideration as a pain generator or modulator in cases of recalcitrant pain of the face and neck. Although uncommon as an etiology of head and neck pain (0.57–1.3 % of cases of facial pain), impingement or injury to the glossopharyngeal nerve can lead to glossopharyngeal neuralgia, a potentially life-threatening disease. Therefore, it is vital that the interventional pain management specialist learns to recognize disease of cranial nerve IX as well as to become facile with techniques of providing analgesia to this important structure.

Keywords

Trigeminal Neuralgia Carotid Sinus Styloid Process Posterior Inferior Cerebellar Artery Glossopharyngeal Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References

  1. 1.
    Harris W. Persistent pain in lesions of the peripheral and central nervous system. Brain (Lond). 1921;44:557.CrossRefGoogle Scholar
  2. 2.
    Chawla JC, Falconer MA. Glossopharyngeal and vagal neuralgia. Br Med J. 1967;3:529–31.PubMedCrossRefGoogle Scholar
  3. 3.
    Fraioli B, Esposito V, Ferrante L, Trubiani L, Lunardi P. Microsurgical treatment of glossopharyngeal neuralgia: case reports. Neurosurgery. 1989;25:630–2.PubMedCrossRefGoogle Scholar
  4. 4.
    Weinstein RE, Herec D, Friedman JH. Hypotension due to glossopharyngeal neuralgia. Arch Neurol. 1986;43:90–2.PubMedCrossRefGoogle Scholar
  5. 5.
    Kong Y, Heyman A, Entman ML, McIntosh HD. Glossopharyngeal neuralgia associated with bradycardia, syncope, and seizures. Circulation. 1964;30:109–13.PubMedCrossRefGoogle Scholar
  6. 6.
    Weisenburg TH. Cerebello-pontine tumor diagnosed for six years as a tic douloureux. The symptoms of irritation of the ninth and twelfth cranial nerves. J Am Med Assoc (Chic). 1910;54:1600–4.CrossRefGoogle Scholar
  7. 7.
    Sicard R, Robineau J. Communications et presentations: I Algie velo-pharyngeal essentielle, traitement chirurgical. Rev Neurol. 1920;36:256.Google Scholar
  8. 8.
    Dandy WE. Glossopharyngeal neuralgia (tic douloureux). Arch Surg. 1927;15:I98.Google Scholar
  9. 9.
    Rushton JG, Stevens JC, Miller RH. Glossopharyngeal (vagoglossopharyngeal) neuralgia: a study of 217 cases. Arch Neurol. 1981;38:201–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Katusic S, Williams DB, Beard CM, Bergstralh E, Kurland LT. Incidence and clinical features of glossopharyngeal neuralgia, Rochester, Minnesota, 1945–1984. Neuroepidemiology. 1991;10:266–75.PubMedCrossRefGoogle Scholar
  11. 11.
    Ferrante L, Artico M, Nardacci B, Fraioli B, Consentino F, Fortuna A. Glossopharyngeal neuralgia with cardiac syncope. Neurosurgery. 1995;36:58–63.PubMedCrossRefGoogle Scholar
  12. 12.
    Karnosh LJ, Gardner WJ, Stowell A. Glossopharyngeal neuralgia: physiological consideration of the role of ninth and tenth cranial nerves–report of cases. Trans Am Neurol Assoc. 1947;72:205–7.Google Scholar
  13. 13.
    Takaya N, Sumiyoshi M, Nakata Y. Prolonged cardiac arrest caused by glossopharyngeal neuralgia. Heart. 2003;89:381.PubMedCrossRefGoogle Scholar
  14. 14.
    Varrasi C, Strigaro G, Prandi P, Comi C, Mula M, Monaco F, Cantello RM. Complex pattern of convulsive syncope in glossopharyngeal neuralgia: video/EEG report and short review. Epilepsy Behav. 2011;20:407–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Soh KB. The glossopharyngeal nerve, glossopharyngeal neuralgia and the Eagle’s syndrome–current concepts and management. Singapore Med J. 1999;40:659–65.PubMedGoogle Scholar
  16. 16.
    Kawashima M, Matsushima T, Inoue T, Mineta T, Masuoka J, Hirakawa N. Microvascular decompression for glossopharyngeal neuralgia through the transcondylar fossa (supracondylar transjugular tubercle) approach. Neurosurgery. 2010;66:275–80.PubMedCrossRefGoogle Scholar
  17. 17.
    Resnick DK, Jannetta PJ, Bissonnette D, et al. Microvascular decompression for glossopharyngeal neuralgia. Neurosurgery. 1995;36:64–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Kondo A. Follow-up results of using microvascular decompression for treatment of glossopharyngeal neuralgia. J Neurosurg. 1998;88:221–5.PubMedCrossRefGoogle Scholar
  19. 19.
    Dykman TR, Montgomery Jr EB, Gerstenberger PD, Zeiger HE, Clutter WE, Cryer PE. Glossopharyngeal neuralgia with syncope secondary to tumor: treatment and pathophysiology. Am J Med. 1981;71:165–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Sobol SM, Wood BG, Conoyer JM. Glossopharyngeal neuralgia-asystole syndrome secondary to parapharyngeal space lesions. Otolaryngol Head Neck Surg. 1982;90:16–9.PubMedGoogle Scholar
  21. 21.
    Waga S, Kojima T. Glossopharyngeal neuralgia of traumatic origin. Surg Neurol. 1982;17:77–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Kahana E, Leibowitz U, Alter M. Brainstem and cranial nerve involvement in multiple sclerosis. Acta Neurol Scand. 1973;49:269–79.PubMedCrossRefGoogle Scholar
  23. 23.
    Shin JH, Herrera SR, Eboli P, Aydin S, Eskandar EH, Slavin KV. Entrapment of the glossopharyngeal nerve in patients with Eagle syndrome: surgical technique and outcomes in a series of 5 patients. J Neurosurg. 2009;111:1226–30.PubMedCrossRefGoogle Scholar
  24. 24.
    Carrieri PB, Montella S, Petracca M. Glossopharyngeal neuralgia as onset of multiple sclerosis. Clin J Pain. 2009;25:737–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Fukuda H, Ishikawa M, Yamazoe N. Glossopharyngeal neuralgia caused by adhesive arachnoid. Acta Neurochir. 2002;144:1057–8.CrossRefGoogle Scholar
  26. 26.
    Aicardi J. Disorders of the peripheral nerves. In: Aicardi J, editor. Diseases of the nervous system in childhood. London: MacKeith Press; 1998. p. 733.Google Scholar
  27. 27.
    Park HP. The effects of glossopharyngeal nerve block on postoperative pain relief after tonsillectomy: the importance of the extent of obtunded gag reflex as a clinical indicator. Anesth Analg. 2007;105:267–71.PubMedCrossRefGoogle Scholar
  28. 28.
    Waldman SD. The role of neural blockade in the management of headaches and facial pain. Headache Dig. 1991;4:286–92.Google Scholar
  29. 29.
    Waldman SD, Waldman KA. The diagnosis and treatment of glossopharyngeal neuralgia. Am J Pain Manag. 1995;5:19–24.Google Scholar
  30. 30.
    Waldman SD. The role of neural blockade in the management of headaches and facial pain. Curr Rev Pain. 1997;1:346–52.Google Scholar
  31. 31.
    Benumof JL. Management of the difficult adult airway. Anesthesiology. 1991;75:1084–6.CrossRefGoogle Scholar
  32. 32.
    Gallacher BP, Martin L. Treatment of refractory hiccups with glossopharyngeal nerve block. Anesth Analg. 1997;84:229.PubMedGoogle Scholar
  33. 33.
    Kodama K, Seo N, Murayama T, Yoshizawa Y, Terasako K, Yaginuma T. Glossopharyngeal nerve block for carotid sinus syndrome. Anesth Analg. 1992;75:1036–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Hiwatashi A, Matsushima T, Yoshiura T, Tanaka A, Noguchi T, Togao O, Yamashita K, Honda H. MRI of glossopharyngeal neuralgia caused by neurovascular compression. AJR Am J Roentgenol. 2008;191:578–81.PubMedCrossRefGoogle Scholar
  35. 35.
    Gaul C, Hastreiter P, Duncker A, Naraghi R. Diagnosis and neurosurgical treatment of glossopharyngeal neuralgia: clinical findings and 3-D visualization of neurovascular compression in 19 consecutive patients. J Headache Pain. 2011;12:527–34.PubMedCrossRefGoogle Scholar
  36. 36.
    Hasegawa S, Morioka M, Kai Y, Kuratsu J. Usefulness of balloon test occlusion in the diagnosis of glossopharyngeal neuralgia. Case report. Neurol Med Chir (Tokyo). 2008;48:163–6.CrossRefGoogle Scholar
  37. 37.
    Matsushima T, Goto Y, Ishioka H, Mihara F, Fukui M. Possible role of an endovascular provocative test in the diagnosis of glossopharyngeal neuralgia as a vascular compression syndrome. Acta Neurochir (Wien). 1999;141:1229–32.CrossRefGoogle Scholar
  38. 38.
    Dworkin R, Backonja M, Rowbotham MC, Allen R, Argoff C, Bennett G, Bushnell MC, Farrar JT, Galer BS, Haythornthwaite JA, Hewitt DJ, Loeser JD, Max MB, Saltarelli M, Schmader KE, Stein C, Thombson D, Turk DC, Wallace MS, Watkins LR, Weinstein SM. Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol. 2003;60:1524–34.PubMedCrossRefGoogle Scholar
  39. 39.
    Kouzaki Y, Takita T, Tawara S, Otsuka T, Hirano T, Uchino M. Opioid effectiveness for neuropathic pain in a patient with glossopharyngeal neuralgia. Rinsho Shinkeigaku. 2009;49:364–9.PubMedCrossRefGoogle Scholar
  40. 40.
    Finnerup NB, Otto M, McQuay HK, Jensen TS, Sindrup SH. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain. 2005;118:289–305.PubMedCrossRefGoogle Scholar
  41. 41.
    Cheshire Jr WP. Defining the role for gabapentin in the treatment of trigeminal neuralgia: a retrospective study. J Pain. 2002;3:137–42.PubMedCrossRefGoogle Scholar
  42. 42.
    Titlic M, Jukic I, Tonkic A, Grani P, Jukic J. Use of lamotrigine in glossopharyngeal neuralgia: a case report. Headache. 2006;46:167–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Saviolo R, Fiascanoro G. Treatment of glossopharyngeal neuralgia by carbamazepine. Br Heart J. 1987;58:291–2.PubMedCrossRefGoogle Scholar
  44. 44.
    Ekbom KA, Westerberg CE. Carbamazepine in glossopharyngeal neuralgia. Arch Neurol. 1966;14:595–6.PubMedCrossRefGoogle Scholar
  45. 45.
    Funasaka S, Kodera K. Intraoral nerve block for glossopharyngeal neuralgia. Arch Otorhinolaryngol. 1977;215:311–5.PubMedCrossRefGoogle Scholar
  46. 46.
    Isamat F, Ferran E, Acebes JJ. Selective percutaneous thermocoagulation rhizotomy in essential glossopharyngeal neuralgia. J Neurosurg. 1981;55:575–80.PubMedCrossRefGoogle Scholar
  47. 47.
    Tew Jr JM. Treatment of pain of glossopharyngeal and vagus nerves by percutaneous rhizotomy. In: Youmans JR, editor. Neurological surgery. Philadelphia: W.B. Saunders Co; 1982. p. 3609–12.Google Scholar
  48. 48.
    Bedder MD, Lindsay D. Glossopharyngeal nerve block using ultrasound guidance: a case report of a new technique. Reg Anesth. 1989;14:304–7.PubMedGoogle Scholar
  49. 49.
    Isbir CA. Treatment of a patient with glossopharyngeal neuralgia by the anterior tonsillar pillar method. Case Rep Neurol. 2011;3:27–31.PubMedCrossRefGoogle Scholar
  50. 50.
    Katz J. Glossopharyngeal nerve block. Atlas of regional anesthesia. Norwalk: Appleton and Lange; 1994. p. 54.Google Scholar
  51. 51.
    Saliba DL, McCutchen TA, Laxton MJ, Miller SA, Reynolds JE. Reliable block of the gag reflex in one minute or less. J Clin Anesth. 2009;21:463.PubMedCrossRefGoogle Scholar
  52. 52.
    Nehthorn RW, Amayem A, Ganta R. Which method for intraoral glossopharyngeal nerve block is better? Letters to the Editor. Anesth Analg. 1995;81:1114.Google Scholar
  53. 53.
    Bean-Lijewski JD. Glossopharyngeal nerve block for pain relief after pediatric tonsillectomy: retrospective analysis and two cases of life-threatening upper airway obstruction from an interrupted trial. Anesth Analg. 1997;84:1232–8.PubMedGoogle Scholar
  54. 54.
    Nagashima C, Sakaguchi A, Kamisasa A, Kawanuma S. Cardiovascular complications on upper vagal rootlet section for glossopharyngeal neuralgia; case report. J Neurosurg. 1976;44:248–53.PubMedCrossRefGoogle Scholar
  55. 55.
    Torigoe T, Kato I, Suzuki T, Kenmochi M, Takeyama I. Two cases with glossopharyngeal neuralgia treated by nerve reaction: oropharyngeal approach. Acta Otolaryngol Suppl. 1996;522:142–5.PubMedGoogle Scholar
  56. 56.
    Ceylan S, Karakuş A, Duru S, Baykal S, Koca O. Glossopharyngeal neuralgia: a study of 6 cases. J Neurosurg. 1997;20:196–200.Google Scholar
  57. 57.
    Ferroli P, Fioravanti A, Schiariti M, Tringali G, Franzini A, Calbucci F, Broggi G. Microvascular decompression for glossopharyngeal neuralgia: a long-term retrospectic review of the Milan-Blogna experience in 31 consecutive cases. Acta Neuochir. 2009;151:1245–50.CrossRefGoogle Scholar
  58. 58.
    Kandan SR. Neuralgia of the glossopharyngeal and vagal nerves: long-term outcome following surgical treatment and literature review. Br J Neurosurg. 2010;24(4):441–6.PubMedCrossRefGoogle Scholar
  59. 59.
    Yomo S, Arkha Y, Donnet A, Régis J. Gamma knife surgery for glossopharyngeal neuralgia. J Neurosurg. 2009;110:559–63.PubMedCrossRefGoogle Scholar
  60. 60.
    Koopman JS, Dieleman JP, Huygen FJ, de Mos M, Martin CG, Sturkenboom MC. Incidence of facial pain in the general ­population. Pain. 2009;147:122–7.PubMedCrossRefGoogle Scholar

Copyright information

© American Academy of Pain Medicine 2013

Authors and Affiliations

  1. 1.Department of AnesthesiologyAdvocate Illinois Masonic Medical CenterChicagoUSA
  2. 2.Department of Physical Medicine and RehabilitationRehabilitation Institute of Chicago, Northwestern Memorial HospitalChicagoUSA

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