[Glossopharyngeal neurotomy through laterocervical approach to treat idiopathic glossopharyngeal neuralgia].

OBJECTIVE: To introduce a modified laterocervical approach for glossopharyngeal neurotomy to treat idiopathic glossopharyngeal neuralgia. METHODS: The clinical data, the operative technique, the operative effects and (the results of) follow-up of 12 patients were presented. Through reviewing pertinent literatures, the therapeutic advancement of glossopharyngeal neuralgia and the modified technique of laterocervical approach for glossopharyngeal neurotomy were discussed. New idea on operations, of which the use of insulation coverings when cauterizing the inferior ganglion of glossopharyngeal nerve and Jacobson nerve were brought. Homonymous superior laryngeal nerve was excised at the same time. RESULTS: All patients (the cases) were followed-up for 3 months to 3 years with an median of 15 months. Among the 12 patients suffered from glossopharyngeal neuralgia, 11 patients were satisfied with the outcomes and remained disease free after surgical treatment. The remission rate of pain was 100.0%, complete remission rate of pain was 91.7%. Only a few patients had complications. Intraoperative leakage of cerebrospinal fluid was obstructed with gelatin sponge and pasted with mucilage in 1 case and no complication appeared in the convalescence stage. Postoperatively, facial palsy was found in 1 case which was self-cured after a week, postoperative voice depression in 1 case, and foreign body sensation in 2 cases. CONCLUSIONS: Laterocervical approach for glossopharyngeal neurotomy is an available method to treat idiopathic glossopharyngeal neuralgia.