Fraioli B, Esposito V, Ferrante L, Trubiani L, Lunardi P
Department of Neurological Sciences, University of Rome La Sapienza, Italy.
Neurosurgery. 1989 Oct;25(4):630-2. doi: 10.1097/00006123-198910000-00018.
Three patients with excruciating glossopharyngeal neuralgia underwent microsurgical operations in the posterior cranial fossa. In each patient, neurovascular compression was found involving the posteroinferior cerebellar artery and involving the 9th and 10th cranial nerves. In two of the patients, the compression was caused by arachnoiditis and in the other by an arterial loop. In each patient, neuralgia was successfully eliminated by microvascular decompression and by section of the upper rootlets of the vagus nerve. In one patient, partial section of the 9th cranial nerve was also performed. Because of the frequent involvement of the vagus nerve in the pathogenesis of this condition, open surgery should be preferable to percutaneous thermorhizotomy, which is unable to act selectively on the 10th cranial nerve.
三名患有剧烈舌咽神经痛的患者在颅后窝接受了显微外科手术。在每例患者中，均发现存在神经血管压迫，累及小脑后下动脉以及第9和第10对脑神经。其中两名患者的压迫是由蛛网膜炎引起的，另一名患者是由动脉襻引起的。在每例患者中，通过微血管减压和切断迷走上神经根，神经痛均成功消除。在一名患者中，还对第9对脑神经进行了部分切断。由于迷走神经在该疾病发病机制中经常受累，开放性手术应优于经皮热凝术，因为经皮热凝术无法选择性地作用于第10对脑神经。
