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

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