Patel Atul, Kassam Amin, Horowitz Michael, Chang Yue-Fang
Department of Neurological Surgery, Center for Cranial Nerve Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Neurosurgery. 2002 Apr;50(4):705-10; discussion 710-1. doi: 10.1097/00006123-200204000-00004.
Glossopharyngeal neuralgia (GPN) is a rare condition that often presents with the seemingly benign symptom of deep throat pain. Medical management of this condition has not been very effective, and surgical therapy has ranged from nerve sectioning to microvascular decompression (MVD). We present our experience with more than 200 patients who underwent MVD for treatment of GPN at our institution.
We conducted a retrospective review of our database and identified patients who presented for treatment of presumed GPN. When possible, patients were contacted by telephone for collection of follow-up information regarding symptom relief, complications, functional outcomes, and patient satisfaction. Univariate and multivariate analyses were performed to identify predictors of good outcomes after MVD. Subgroup analyses were performed with quartiles of approximately 50 patients each, for assessment of the effects of improvements in techniques and anesthesia during this 20-year period.
We observed GPN to be more common among female (66.8%) than male (33.2%) patients, with an overall mean patient age of 50.2 years (standard deviation, 14.4 yr). The most common presenting symptoms were throat and ear pain and throat pain alone, and the mean duration of symptoms was 5.7 years (standard deviation, 5.8 yr; range, 1-32 yr). Symptoms appeared almost equally on the left side (54.8%) and the right side (45.2%). The overall immediate success rate exceeded 90%, and long-term patient outcomes and satisfaction were best for the typical GPN group (with pain restricted to the throat and palate). Complication rates decreased across quartiles for all categories evaluated.
MVD is a safe, effective form of therapy for GPN. It may be most beneficial for patients with typical GPN, especially when symptoms are restricted to deep throat pain only.
舌咽神经痛（GPN）是一种罕见疾病，常表现为看似良性的深部咽痛症状。该疾病的药物治疗效果不佳，手术治疗方法包括神经切断术和微血管减压术（MVD）。我们介绍了在本机构接受MVD治疗GPN的200多名患者的治疗经验。
我们对数据库进行了回顾性分析，确定了前来治疗疑似GPN的患者。尽可能通过电话联系患者，收集有关症状缓解、并发症、功能结局和患者满意度的随访信息。进行单因素和多因素分析以确定MVD后良好结局的预测因素。进行亚组分析，每组约50例患者，共分为四个四分位数组，以评估这20年期间技术和麻醉改进的效果。
我们观察到GPN在女性患者（66.8%）中比男性患者（33.2%）更常见，患者总体平均年龄为50.2岁（标准差，14.4岁）。最常见的症状是咽痛和耳痛以及单纯咽痛，症状平均持续时间为5.7年（标准差，5.8年；范围，1 - 32年）。症状出现在左侧（54.8%）和右侧（45.2%）的几率几乎相同。总体即时成功率超过90%，典型GPN组（疼痛仅限于咽喉和腭部）的长期患者结局和满意度最佳。所有评估类别的并发症发生率在四分位数组中均有所下降。
MVD是治疗GPN的一种安全、有效的治疗方式。对于典型GPN患者可能最为有益，尤其是当症状仅限于深部咽痛时。
