English
Arabic
Chinese (Simplified)
Dutch
French
German
Italian
Portuguese
Russian
Spanish
- Department of Neurosurgery, Medical College of Georgia, Augusta, Georgia, United States,
- Department of Neurosurgery, Georgia Neurological Surgery and Comprehensive Spine, Athens, Georgia, United States.
Correspondence Address:
Tejas Arvind Sardar, Department of Neurosurgery, Medical College of Georgia, Augusta, Georgia, United States.
DOI:10.25259/SNI_1030_2021
Copyright: © 2021 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.How to cite this article: Tejas Arvind Sardar1, Viren S. Vasudeva2, M. Neil Woodall2. Microvascular decompression for a unique case of glossopharyngeal neuralgia with provokable symptomatic bradycardia: 2-Dimensional operative video. 23-Nov-2021;12:570
How to cite this URL: Tejas Arvind Sardar1, Viren S. Vasudeva2, M. Neil Woodall2. Microvascular decompression for a unique case of glossopharyngeal neuralgia with provokable symptomatic bradycardia: 2-Dimensional operative video. 23-Nov-2021;12:570. Available from: https://surgicalneurologyint.com/?post_type=surgicalint_articles&p=11245
Date of Submission
10-Oct-2021
Date of Acceptance
05-Nov-2021
Date of Web Publication
23-Nov-2021
Abstract
Background: Glossopharyngeal neuralgia is a rare neurovascular compression syndrome that can lead to paroxysmal craniofacial pain and sometimes cardiovascular symptoms.[
Case Description: A 72-year-old male presented to the ED following four episodes of syncope. The patient had a multi-year history of right-sided burning/stabbing pain involving the submandibular area and posterior throat. His syncope was related to symptomatic bradycardia that would occur during episodes of pain. His pain was exacerbated by speaking and swallowing and could be triggered by placing his finger in the right external auditory meatus. Interestingly, this maneuver would also trigger his bradycardia. The patient had failed previous pharmacotherapy, and a pacemaker had been placed to protect him from periods of hypotension. MRI/MRA of the brain and cervical spine were unremarkable. Due to his profoundly symptomatic status, the patient was offered a right retrosigmoid craniotomy for microvascular decompression of the right glossopharyngeal nerve. The patient had complete resolution of his pain and bradycardia immediately post-operatively. He was discharged on the second postoperative day and his pacemaker was ultimately removed. The patient continues to be pain free and off medication.
Conclusion: Here we present a video case report of microvascular decompression with favorable outcome for an interesting presentation of glossopharyngeal neuralgia. The patient gave informed consent for surgery and video recording.
Keywords: Glossopharyngeal neuralgia, Microsurgery, Microvascular decompression, Retrosigmoid approach
Video 1
Annotations[1,2]
0:00 – clinical presentation. 1:44 – Rationale, risks, benefits of procedure. 2:32 – Surgical setup and key steps. 3:06 – Dissection to CP angle cistern. 5:15 – Exposure of vascular compression. 6:51 – Pledget placement. 7:46 – Disease background. 8:50 – Clinical outcome.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1. Baldauf J, Rosenstengel C, Schroeder HW. Nerve compression syndromes in the posterior cranial fossa. Dtsch Arztebl Int. 2019. 116: 54-60
2. Franzini A, Moosa S, D’Ammando A, Bono B, Scheitler-Ring K, Ferroli P. The neurosurgical treatment of craniofacial pain syndromes: Current surgical indications and techniques. Neurol Sci. 2019. 40: 159-68
