gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Favorable results of microvascular decompression in glossopharyngeal neuralgia

Besondere Ergebnisse der mikrovaskulären Dekompression bei der Glossopharyngeusneuralgie

Meeting Abstract

  • corresponding author L. Tanrikulu - Neurochirurgische Universitätsklinik Erlangen
  • P. Hastreiter - Neurochirurgische Universitätsklinik Erlangen
  • G. Richter - Neuroradiologische Abteilung der Universität Erlangen
  • A. Doerfler - Neuroradiologische Abteilung der Universität Erlangen
  • M. Buchfelder - Neurochirurgische Universitätsklinik Erlangen
  • R. Naraghi - Neurochirurgische Universitätsklinik Erlangen

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMI.08.12

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Tanrikulu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Glossopharyngeal neuralgia (GN) is a rare entity. Correct diagnosis and neurosurgical management are still a great challenge. GN has been associated with neurovascular compression (NVC) and microvascular decompression (MVD) is reported to be effective in selected cases. Standardized criteria for the diagnosis and treatment do not exist. In this study we present a consecutive series of 14 patients with GN, who were evaluated regarding the clinical appearance and detection of NVC by modern imaging and image processing. The impact of 3D visualization with intraoperative application is analyzed this study.

Methods: A consecutive series of 14 patients with GN was studied. Detailed clinical history, high resolution MRCISS images and interactive 3D visualization were analyzed to detect NVC. MVD was performed with the intraoperative application of 3D visualization and monitoring of the vocal cord and acoustic evoked potentials.

Results: 3D visualization identified the PICA as the causative vessel in 13 cases (93%) and the vertebral artery in 1 (7%) case. Veins were not found to cause NVC. Tumors were excluded by preoperative imaging. 13 of 14 patients (93%) underwent surgery. All operated patients (100%) experienced pain relief after MVD. Two patients were previously operated in other hospitals, which had led to initial pain relief. One patient (7%) was not operated because of intermittent pain relief under conservative medication. The relevant neurovascular structures in 3D visualization were confirmed by the intraoperative findings in all 13 patients (100%). Transient vocal cord paresis and transient swallowing difficulties occured in two cases. There was no postoperative hearing deficit.

Conclusions: In patients with GN we can confirm NVC by 3D visualization. We could achieve favorable results with MVD even in cases of previously operated patients. Interactive 3D visualization is a reliable and standard method for supporting the diagnosis and especially microneurosurgery in the posterior fossa. The experience gained in this series, which is one of the largest, suggests a straightforward management of GN by MVD.