Stereotactic radiosurgery for glossopharyngeal neuralgia: preliminary report of 5 cases

Clinical article

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Glossopharyngeal neuralgia (GPN) is a rare pain disorder characterized by severe, stabbing pain of the ear, posterior tongue, and throat. The authors report their early experience of using stereotactic radiosurgery (SRS) as an alternative to posterior fossa surgery for patients with medically resistant GPN.


Five patients (3 men, 2 woman) with medically resistant GPN underwent Gamma Knife surgery. The radiosurgical target was the distal portion of the glossopharyngeal and vagus nerves at the jugular foramen (glossopharyngeal meatus). The maximum radiation dose in all cases was 80 Gy. The median follow-up after radiosurgery was 13 months (range 2–19 months).


Three patients became pain-free at 2 days, 3 days, and 2 weeks, respectively, and were able to discontinue the medications taken preoperatively for their pain. None of these patients have suffered recurrent pain since becoming pain free. Two patients experienced no benefit from the procedure and underwent posterior fossa surgery 2 and 5 months after SRS. Both of these patients continued to have pain after posterior fossa surgery. One of these patients was later discovered to have a head and neck cancer as the cause of his pain. No patient developed hoarseness or dysphagia after radiosurgery.


This preliminary experience demonstrates that SRS is an option for patients with medically resistant GPN. Additional follow-up and a larger number of patients are needed to demonstrate the long-term safety and optimal radiation dosimetry for this indication.

Abbreviations used in this paper: GPN = glossopharyngeal neuralgia; MVD = microvascular decompression; SRS = stereotactic radiosurgery.

Article Information

Address correspondence to: Bruce E. Pollock, M.D., Department of Neurological Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905. email:

Please include this information when citing this paper: published online July 8, 2011; DOI: 10.3171/2011.5.JNS1133.

© AANS, except where prohibited by US copyright law.



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    Axial images showing the radiosurgical target in a representative patient. Left: Fused, Gd-enhanced, spoiled gradient–recalled acquisition MR imaging sequence and CT scan showing radiosurgical dose plan (circles) targeting the glossopharyngeal nerve (arrowhead) at the level of the glossopharyngeal meatus. The maximum prescribed radiation dose was 80 Gy. Right: Computed tomography scan demonstrating the adjacent anatomy: pars nervosa of the jugular foramen (asterisk), jugular bulb (arrowhead), carotid canal (arrow).



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