Glossopharyngeal Neuralgia: MVD vs GKS

Background: Glossopharyngeal neuralgia (GPN) is a rare condition typified by paroxysmal episodes of pain along the branches of the glossopharyngeal nerve (CN IX). Its incidence is 7:1,000,000 per year and due to its low incidence, the disease is misjudged. This study aims to present the patient clinically and the therapeutic options.

Methods: We performed a literature review using PUBMED, Clinical Key and Google Scholar. We analyzed 29 articles and the data from 6058 patients that presented with GPN.

Results: The sex incidence showed a small variation. The patients are usually older than 50 years old. The most affected side is the left. The neuroimaging plays a key role to the diagnoses allied with the peculiar pain characterization. Often, GPN is associated with trigeminal neuralgia and hemifacial spasm and it’s usually associated with vagus symptoms due to their localization. The posterior circulation is the main cause for the disease and the PICA is the main artery related to the GPN. Comparing Microvascular Decompression (MVD) and Gamma Knife surgery (GKS), we concluded that MVD showed better initial outcomes than GKS, once MVD presented an Odds Ratio (O.R.) of 7,2; it increases in 46,4% the chance to present an initial good outcome and those values were statistically relevant. Comparing the surgical retreatment ratio and the use of medication after the procedures we also can see better results of MVD.

Conclusion: MVD and GKS are important surgical procedures for this disease. However, MVD showed better results, especially when it comes to initial good outcomes.

Keywords: Glossopharyngeal; Neuralgia; Treatment; Causes; MVD and GKS