The Surgical Treatment And Effect Of The Treatment Of Glossopharyngeal Neuralgia

Objective: There are many means of glossopharyngeal neuralgiatreatment, each approach to a certain extent alleviate the pain, bu t there arecertain recu rrence rate and complications. Rhizotomy， microvasculardecompression or rhizotomy joint microvascu lar decompression by thesu boccipital retrosigmoid approach are normal operation methods oftreating idiopathic glossopharyngeal neuralgia. In this paper, Weretrospectively evaluated66glossopharyngeal neu ralgia patients whounderwent rhizotomy， microvascu lar decompression or rhizotomy jointmicrovascular decompression. To explore the characteristics of general andclinical datas and the su rgical treatment effects, gu idance for the fu ture ofthe su rgical treatment and prevention of postoperative complications toprovide clinical basis.Methods: Retrospectively analysis66glossopharyngeal neuralgiapatients who underwent rhizotomy， microvascular decomp ression orrhizotomy joint microvascular decompression by the suboccipitalretrosigmoid approach from Au gu st2005to Ju ne2013. All patients were followed u p eight to eight-four months,ru n a systematic statistical analysisof the in-hospital and follow-u p datas.Results: T here are24males and42females in all the66cases in thisstu dy, the left side in36,the right side in30. T he mean age was57.7years,maximu m was78years, minimu m age was36years. All patients wereperformed CT or MRI to excluse sencondary factors,for a definitive diagnosis ofidiopathic glossopharyngeal neu ralgia.All the66cases were performed a rhizotomy， microvascu lardecompression or rhizotomy joint microvascular decompression by thesu boccipital retrosigmoid approach. T he66cases of patients withglossopharyngeal neu ralgia, were carried a glossopharyngeal nerve M VDsinglely in6,combined a Rhizotomy in20, a vagotomy whileglossopharyngeal rhizotomy in40.61cases were cured immediately after asu rgical operation and relieved in5, none of deaths.1case occurred delayedcerebellu m hemorrhage the second day, when the patient finally dischargedfrom hospital was cure and left no obviou s sequ elae after evacuation ofintracranial hematoma. Difficu lty swallowing, drink ing cou gh, hoarsenesssymptoms in1case; Pure hoarseness in2cases; Pharyngeal foreign bodysensation in2cases;Facial paralysis in1case;Hearing loss in4cases;5cases of postoperative headache.All patients were followed u p for8-84months,the mean follow-u pperiod is30.6months.One of61cases of postoperative pain relief was recurrence one year later after surgery. Two of5cases of partial pain reliefwere complete pain relief one year later after su rgery, the remainingthree cases can control the symptoms by the medicine conservativetreatment.Conclusion:1. Performing MRI for the patients with glossopharyngeal neuralgiabefore su rgery can help u s in excu lding a secondary factor,affirming themovement of cranial nerves and the vessels in the CPA(cerebello-pontineangle).2.To choose which operation metho d shou ld be decided by whetherthe compression of nerve roots by affected vessels and the condition ofcompression. Have clear responsibility blood vessels, should give MVD; Noclear responsibility blood vessels can give rhizotomy,it is R; Responsibilityof vascular compression is not clear or there is a clear responsibilityvascu lar compression but becau se of variou s reasons could not be fullydecompression,shou ld give MVD joint R.3.Three microsu rgical treatments are safe and efficient.