neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2021-23-2-77-85neurosurgery-1034Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEВаскулярная декомпрессия с применением видеоэндоскопии как метод лечения классической невралгии языкоглоточного нерва: клиническое наблюдение и обзор литературыVascular decompression with videoendoscopy as a treatment for glossopharyngeal nerve neuralgia: clinical case and literature reviewВинокуровА. Г.VinokurovA. G.

115682 Москва, Ореховый бульвар, 28

28 Orekhovy Blvd, Moscow 115682

https://orcid.org/0000-0002-1605-9088КалинкинА. А.KalinkinA. A.

Александр Александрович Калинкин

115682 Москва, Ореховый бульвар, 28

Aleksandr Aleksandrovich KaLinkin

28 Orekhovy Blvd, Moscow 115682

aleksandr_kalinkin27@mail.ruБочаровА. А.BocharovA. A.

115682 Москва, Ореховый бульвар, 28

28 Orekhovy Blvd, Moscow 115682

https://orcid.org/0000-0001-5538-904XКалинкинаО. Н.KalinkinaO. N.

127473 Москва, ул. Делегатская, 20, стр. 1

Bld. 1, 20 Delegatskaya St., Moscow 127473

https://orcid.org/0000-0001-5994-3124ЧупаленковС. М.ChupalenkovS. M.

117997Москва, ул. Островитянова, 1

1 Ostrovityanova St., Moscow 117997

ФГБУ Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА РоссииРоссияFederal Research Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of RussiaRussian FederationФГБОУ ВО Московский государственный медико-стоматологический университет им. А.И. Евдокимова Минздрава РоссииРоссияA.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of RussiaRussian FederationФГАОУ Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава РоссииРоссияN.I. Pirogov Russian National Research Medical UniversityRussian Federation2021100620212327785Copyright © Винокуров А.Г., Калинкин А.А., Бочаров А.А., Калинкина О.Н., Чупаленков С.М., 20212021Винокуров А.Г., Калинкин А.А., Бочаров А.А., Калинкина О.Н., Чупаленков С.М.Vinokurov A.G., Kalinkin A.A., Bocharov A.A., Kalinkina O.N., Chupalenkov S.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1034

Цель публикации - на клиническом примере продемонстрировать эффективность васкулярной декомпрессии с применением видеоэндоскопи в лечении классической невралгии языкоглоточного нерва и обобщить данные научной литературы по этому вопросу.

Клиническое наблюдение

Клиническое наблюдение. В Федеральный научно-клинический центр ФМБА России в феврале 2020 г. поступила пациентка 56 лет с клинической картиной невралгии языкоглоточного нерва. Болевой синдром беспокоил около 3 лет. Постоянно принимала карбамазепин в дозе 1200 мг в сутки, амитриптилин - 75 мг в сутки, клоназепам - 2 мг в сутки без эффекта. По результатам дообследования и дифференциальной диагностики установлена причина невралгии языкоглоточного нерва - нейроваскулярный конфликт между языкоглоточным нервом, задней нижней мозжечковой и позвоночной артериями. Получен хороший послеоперационный клинический результат. После выполнения васкулярной декомпрессии корешка языкоглоточного и блуждающего нервов боль полностью регрессировала (BNI - I, ВАШ - 0). Через 6 мес после операции болевого синдрома нет, медикаментозную терапию пациентка не получает. Согласно данным литературы, эффективность васкулярной декомпрессии в лечении пациентов с классической невралгией достигает 98 %.

Заключение

Заключение. Ввиду низкой частоты невралгии языкоглоточного нерва правильная постановка диагноза и выбор адекватного метода лечения определяют исход заболевания. Васкулярная декомпрессия корешка языкоглоточного нерва с видеоэндоскопической ассистенцией позволила полностью купировать болевой синдром.

The objective is to demonstrate the effectiveness of the vascular decompression with videoendoscopy in the treatment of classical glossopharyngeal nerve neuralgia by a clinical case and to summarize the literature data on this subject. Clinical case. In February 2020, a 56-year-old patient with a clinical picture of glossopharyngeal nerve neuralgia was admitted to the Research Clinical Center of Specialized Medical Care and Medical Technologies. The pain syndrome bothered about 3 years, constantly took carbamazepine at a dose of 1200 mg per day, amitriptyline 75 mg per day, clonazepam 2 mg per day without effect. After further examination and differential diagnosis of causal neuralgia of the glossopharyngeal nerve, a neurovascular conflict appeared between the glossopharyngeal nerve, the posterior inferior cerebellar and vertebral arteries. A good postoperative clinical result was obtained. An analysis of the available scientific literature on this problem is carried out.

Results

Results. After performing vascular decompression of the root of the glossopharyngeal and vagus nerves, pain completely regressed (BNI - I, VAS - 0). 6 months after surgery, there is no pain, the patient does not receive drug therapy. In the course of the analysis of available literature, the effectiveness of vascular decompression in the treatment of patients with classical neuralgia reaches 98 %.

Conclusion

Conclusion. Given the low incidence of glossopharyngeal neuralgia, the correct diagnosis and the choice of an appropriate treatment method determine the outcome of the disease. The performed operation in the volume of vascular decompression of the glossopharyngeal nerve root with the use of videoendoscopy allowed to completely stop the pain syndrome.

невралгия языкоглоточного нерваваскулярная декомпрессияязыкоглоточный нервзадняя нижняя мозжечковая артерияпозвоночная артерияglossopharyngeal nerve neuralgiavascular decompressionglossopharyngeal nerveposterior inferior cerebellar arteryvertebral arteryReferencesHeadache Classification Committee of the International Headache Society (2013). The international classification of headache disorders. 3rd edn. (beta version). Cephalalgia 2013;33(9):629—808. DOI: 10.1177/0333102413485658.Headache Classification Committee of the International Headache Society (2013). The international classification of headache disorders. 3rd edn. (beta version). Cephalalgia 2013;33(9):629—808. DOI: 10.1177/0333102413485658.Katusic S., Williams D.B., Beard C.M. et al. Incidence and clinical featuresof glossopharyngeal neuralgia, Rochester, Minnesota, 1945-1984. Neuroepidemiology 1991;10(5—6):266—75. DOI: 10.1159/000110283.Katusic S., Williams D.B., Beard C.M. et al. Incidence and clinical featuresof glossopharyngeal neuralgia, Rochester, Minnesota, 1945-1984. Neuroepidemiology 1991;10(5—6):266—75. DOI: 10.1159/000110283.Ferrante L., Artico M., Nardacci B. et al. Glossopharyngeal neuralgia with cardiac syncope. Neurosurgery 1995;36(1):58—63. DOI: 10.1227/00006123-199501000-00007.Ferrante L., Artico M., Nardacci B. et al. Glossopharyngeal neuralgia with cardiac syncope. Neurosurgery 1995;36(1):58—63. DOI: 10.1227/00006123-199501000-00007.Esaki T., Osada H., Nakao Y. et al. Surgical management for glossopharyngeal neuralgia associated with cardiac syncope: two case reports. Br J Neurosurg 2007;21(6):599—602. DOI: 10.1080/02688690701627138.Esaki T., Osada H., Nakao Y. et al. Surgical management for glossopharyngeal neuralgia associated with cardiac syncope: two case reports. Br J Neurosurg 2007;21(6):599—602. DOI: 10.1080/02688690701627138.Kandan S.R., Khan S., Jeyaretna D.S. et al. Neuralgia of the glossopharyngeal and vagal nerves: long-term outcome following surgical treatment and literature review. Br J Neurosurg 2010;24(4):441—6. DOI: 10.3109/02688697.2010.487131.Kandan S.R., Khan S., Jeyaretna D.S. et al. Neuralgia of the glossopharyngeal and vagal nerves: long-term outcome following surgical treatment and literature review. Br J Neurosurg 2010;24(4):441—6. DOI: 10.3109/02688697.2010.487131.Gaul C., Hastreiter P., Duncker A., Naraghi R. Diagnosis and neurosurgical treatment of glossopharyngeal neuralgia: clinical findings and 3-D visualization of neurovascular compression in 19 consecutive patients. J Headache Pain 2011;12(5):527—34. DOI: 10.1007/s10194-011-0349-x.Gaul C., Hastreiter P., Duncker A., Naraghi R. Diagnosis and neurosurgical treatment of glossopharyngeal neuralgia: clinical findings and 3-D visualization of neurovascular compression in 19 consecutive patients. J Headache Pain 2011;12(5):527—34. DOI: 10.1007/s10194-011-0349-x.Kim M.K., Park J.S., Ahn Y.H. Microvascular decompression for glossopharyngeal neuralgia: clinical analyses of 30 cases. J Korean Neurosurg Soc 2017;60(6):738—48. DOI: 10.3340/jkns.2017.0506.010.Kim M.K., Park J.S., Ahn Y.H. Microvascular decompression for glossopharyngeal neuralgia: clinical analyses of 30 cases. J Korean Neurosurg Soc 2017;60(6):738—48. DOI: 10.3340/jkns.2017.0506.010.Weisenberg T.H. Cerebello-pontine tumor diagnosed for six years as tic doloureux; the symptoms of irritation of the ninth and twelfth cranial nerves. J Am Med Ass 1910;54(20):1600—4. DOI: 10.1001/jama.1910.92550460001001g.Weisenberg T.H. Cerebello-pontine tumor diagnosed for six years as tic doloureux; the symptoms of irritation of the ninth and twelfth cranial nerves. J Am Med Ass 1910;54(20):1600—4. DOI: 10.1001/jama.1910.92550460001001g.Sicard R., Robineau V. Algie velo-pharyngee-essentielle: traitment chirurgical. Revue Neurol (Paris) 1920;36:256—7. DOI: 10.1007/s11916-013-0343-x.Sicard R., Robineau V. Algie velo-pharyngee-essentielle: traitment chirurgical. Revue Neurol (Paris) 1920;36:256—7. DOI: 10.1007/s11916-013-0343-x.Harris W. Peristent pain in lesions of the peripheral and central nervous system. Brain 1921;44:557—71. DOI: 10.1136/bmj.2.3178.896.Harris W. Peristent pain in lesions of the peripheral and central nervous system. Brain 1921;44:557—71. DOI: 10.1136/bmj.2.3178.896.Laha R.K., Jannetta PJ. Glossopharyngeal neuralgia. J Neurosurg 1977;47(3):316—20. DOI: 10.3171/jns.1977.47.3.0316.Laha R.K., Jannetta PJ. Glossopharyngeal neuralgia. J Neurosurg 1977;47(3):316—20. DOI: 10.3171/jns.1977.47.3.0316.Hesse E. The surgical treatment of true glossopharyngeal neuralgia. Surg Gynaecol Obstet 1931;52:114-5. DOI: 10.1007/s11916-013-0343-x.Hesse E. The surgical treatment of true glossopharyngeal neuralgia. Surg Gynaecol Obstet 1931;52:114-5. DOI: 10.1007/s11916-013-0343-x.Peet M.M. Glossopharyngeal neuralgia. Ann Surg 1935;101(1):256—68. DOI: 10.1097/00000658-193501000-00026.Peet M.M. Glossopharyngeal neuralgia. Ann Surg 1935;101(1):256—68. DOI: 10.1097/00000658-193501000-00026.Лебедянцев В.В. Шилоподъязычный синдром: топографо-анатомические основы, клиника, диагностика, принципы лечения: автореф. дис. ... д-ра мед. наук. М., 2004. 44 с.Lebedyantsev VV Eagle syndrome: topographic and anatomical fundamentals, clinical picture, diagnosis, principles of treatment: Abstract of dis. ... of doctor of med. sciences. Moscow, 2004. 44 р. (In Russ.).Назарян Д.Н., Караян А.С., Федосов А.В. Хирургические методы лечения шилоподъязычного синдрома. Клиническая практика 2019;10(2):21—6. DOI: 10.17816/clinpract10221-26.Nazaryan D.N., Karayan A.S., Fedosov A.V. Surgical methods of treatment of Eagle syndrome. Klinicheskaya praktika = Journal of Clinical Practice 2019;10(2):21—6. (In Russ.). DOI: 10.17816/clinpract10221-26.Murtagh R.D., Caracciolo J.T., Fernandez G. CT findings associated with eagle syndrome. AJNR Am J Neuroradiol 2001;22(7):1401—2.Murtagh R.D., Caracciolo J.T., Fernandez G. CT findings associated with eagle syndrome. AJNR Am J Neuroradiol 2001;22(7):1401—2.Ghosh L.M., Dubey S.P. The syndrome of elongated styloid process. Auris Nasus Larynx 1999;26(2):169—75. DOI: 10.1016/s0385-8146(98)00079-0.Ghosh L.M., Dubey S.P. The syndrome of elongated styloid process. Auris Nasus Larynx 1999;26(2):169—75. DOI: 10.1016/s0385-8146(98)00079-0.Slavin K.V. Glossopharyngeal neuralgia. Semin Neurosurg 2004;15(1):71—9. DOI: 10.1055/s-2004-830015.Slavin K.V. Glossopharyngeal neuralgia. Semin Neurosurg 2004;15(1):71—9. DOI: 10.1055/s-2004-830015.Rey-Dios R., Cohen-Gadol A.A. Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery. Neurosurg Focus 2013;34:103—22. DOI: 10.3171/2012.12.FOCUS12391.Rey-Dios R., Cohen-Gadol A.A. Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery. Neurosurg Focus 2013;34:103—22. DOI: 10.3171/2012.12.FOCUS12391.Ma Y., Li Y., Wang Q. et al. Neurosurgical treatment of glossopharyngeal neuralgia: analysis of 103 cases. J Neurosurg 2016;124:1088—92. DOI: 10.3171/2015.3.JNS141806.Ma Y., Li Y., Wang Q. et al. Neurosurgical treatment of glossopharyngeal neuralgia: analysis of 103 cases. J Neurosurg 2016;124:1088—92. DOI: 10.3171/2015.3.JNS141806.Akay A., Rükşen M., İşlekel S. A case of vago-glossopharyngeal neuralgia caused by choroid plexus. Asian J Neurosurg 2018;13(2):525—7. DOI: 10.4103/1793-5482.180890.Akay A., Rükşen M., İşlekel S. A case of vago-glossopharyngeal neuralgia caused by choroid plexus. Asian J Neurosurg 2018;13(2):525—7. DOI: 10.4103/1793-5482.180890.Дамулин И.В., Ратбиль О.Е., Шмидт Т.Е., Левченко А.Г. Клиническое наблюдение: невралгия языкоглоточного нерва. Российский журнал боли 2013;2:37—41.Damulin I.V., Ratbil O.E., Schmidt T.E., Levchenko A.G. Glossopharingeal neuralgia: a case report. Rossiyskiy zhurnal boli = Russian Journal of Pain 2013;2:37—41. (In Russ.).Minagar A., Sheremata W.A. Glossopharyngeal neuralgia and MS. Neurology 2000;54(6):1368—70. DOI: 10.1212/wnl.54.6.1368.Minagar A., Sheremata W.A. Glossopharyngeal neuralgia and MS. Neurology 2000;54(6):1368—70. DOI: 10.1212/wnl.54.6.1368.Алиметов Х.А., Шафиева З.Х. Нейропатия верхнегортанного нерва: клиника, диагностика и лечение. Журнал международной медицины 2016;2(19):21—4.Alimetov Kh.A., Shafiyeva Z.Kh. Upper throat nerve neuropathy: clinical presentation, diagnosis and treatment. Zhurnal mezhdunarodnoy meditsiny = Journal of International Medicine 2016;2(19): 21—4. (In Russ.).Eagle W.W. Elongated styloid process: report of two cases. Arch Otolaryngol 1937;25(5):584—6. DOI: 10.1001/archotol.1937.00650010656008.Eagle W.W. Elongated styloid process: report of two cases. Arch Otolaryngol 1937;25(5):584—6. DOI: 10.1001/archotol.1937.00650010656008.Балязина Е.В., Балязин В.А., Яхно Н.Н. Причина редкой встречаемости невралгии языкоглоточного нерва. Неврологический журнал 2014;4:38—43.Balyazina E.V., Balyazin VA, Yakhno N.N. The reason for the rare occurrence of glossopharyngeal nerve neuralgia. Nevrologicheskiy zhurnal = Neurological Journal 2014;4:38—43. (In Russ.).Guclu B., Sindou M., Meyronet D. et al. Cranial nerve vascular compression syndromes of the trigeminal, facial and vago-glossopharingeal nerves: comparative anatomical study of the central myelin portion and transitional zone; correlations with incidences of corresponding hyperactive dysfunctional syndromes. Acta Neurochir (Wien) 2011;153(12):2365—75. DOI: 10.1007/s00701-011-1168-1.Guclu B., Sindou M., Meyronet D. et al. Cranial nerve vascular compression syndromes of the trigeminal, facial and vago-glossopharingeal nerves: comparative anatomical study of the central myelin portion and transitional zone; correlations with incidences of corresponding hyperactive dysfunctional syndromes. Acta Neurochir (Wien) 2011;153(12):2365—75. DOI: 10.1007/s00701-011-1168-1.Мартынова О.А. Патофизиологические механизмы развития тригеминальной невралгии как проявления нейроваскулярной компрессии. Современные подходы к лечению. Вестник совета молодых ученых и специалистов Челябинской области 2017;4(19):82— 5.Martynova O.A. Pathophysiological mechanisms of the development of trigeminal neuralgia as manifestations of neurovascular compression. Modern approaches to treatment. Vestnik soveta molodykh uchenykh i spetsialistov Chelyabinskoy oblasti = Bulletin of the Council of Young Scientists and Specialists of the Chelyabinsk Region 2017;4(19):82— 5. (In Russ.).Horowitz M., Horowitz M., Ochs M. et al. Trigeminal neuralgia and glossopharyngeal neuralgia: two orofacial pain syndromes encountered by dentists. J Am Dent Assoc 2004;135:1427—33. DOI: 10.14219/jada.archive.2004.0052.Horowitz M., Horowitz M., Ochs M. et al. Trigeminal neuralgia and glossopharyngeal neuralgia: two orofacial pain syndromes encountered by dentists. J Am Dent Assoc 2004;135:1427—33. DOI: 10.14219/jada.archive.2004.0052.Kabatas S., Karasu A., Civelek E. et al. Microvascular decompression as a surgical management for trigeminal neuralgia: long-term follow-up and review of the literature. Neurosurg Rev 2009;32(1):87—93. DOI: 10.1007/s10143-008-0171-3.Kabatas S., Karasu A., Civelek E. et al. Microvascular decompression as a surgical management for trigeminal neuralgia: long-term follow-up and review of the literature. Neurosurg Rev 2009;32(1):87—93. DOI: 10.1007/s10143-008-0171-3.Kano H., Urgosik D., Liscak R. et al. Stereotactic radiosurgery for idiopathic glossopharyngeal neuralgia: an international multicenter study. J Neurosurg 2016;125(Suppl 1):147—53. DOI: 10.3171/2016.7.GKS161523.Kano H., Urgosik D., Liscak R. et al. Stereotactic radiosurgery for idiopathic glossopharyngeal neuralgia: an international multicenter study. J Neurosurg 2016;125(Suppl 1):147—53. DOI: 10.3171/2016.7.GKS161523.Вейн А.М., Вознесенская Т.Г., Данилов А.Б. и др. Болевые синдромы в неврологической практике. М.: МЕДпресс, 1999. С. 193—4.Wayne A.M., Voznesenskaya T.G., Danilov A.B. et al. Pain syndromes in neurological practice. Moscow: MEDpress, 1999. Pp. 193—4. (In Russ.).Болезни нервной системы. Руководство для врачей. Том I. Под ред. Н.Н. Яхно, Д.Р. Штульмана. М.: Медицина, 2001. С. 544—5.Diseases of the Nervous System: A Guide for Physicians. Vol. 1. Ed. by N.N. Yakhno, D.R. Shtulman. M.: Medicine, 2001. Pp. 544—5. (In Russ.).Garcia-Callejo FJ., Velert-Vila M.M., Tolamantes-Escriba F. et а! Clinical response of gabapentin for glossopharyngeal neuralgia. Rev Neurol 1999;28:380—4. DOI: 10.33588/rn.2804.98370.Garcia-Callejo FJ., Velert-Vila M.M., Tolamantes-Escriba F. et а! Clinical response of gabapentin for glossopharyngeal neuralgia. Rev Neurol 1999;28:380—4. DOI: 10.33588/rn.2804.98370.Pommier B., Touzet G., Lucas C. et al. Glossopharyngeal neuralgia treated by Gamma Knife radiosurgery: safety and efficacy through long-term follow-up. J Neurosurg 2018;128(5):1372—9. DOI: 10.3171/2017.3.JNS162542.Pommier B., Touzet G., Lucas C. et al. Glossopharyngeal neuralgia treated by Gamma Knife radiosurgery: safety and efficacy through long-term follow-up. J Neurosurg 2018;128(5):1372—9. DOI: 10.3171/2017.3.JNS162542.Wang X., Tang Y., Zeng Y., Ni J. Long-term outcomes of percutaneous radiofrequency thermocoagulation for glossopharyngeal neuralgia. Medicine (Baltimore) 2016;95(48):343—9. DOI: 10.1097/MD.0000000000005530.Wang X., Tang Y., Zeng Y., Ni J. Long-term outcomes of percutaneous radiofrequency thermocoagulation for glossopharyngeal neuralgia. Medicine (Baltimore) 2016;95(48):343—9. DOI: 10.1097/MD.0000000000005530.Olds M.J., Woods C., Wineld J.A. Microvascular decompression in glossopharyngeal neuralgia. Am J Otol 1995;16(3):326—30.Olds M.J., Woods C., Wineld J.A. Microvascular decompression in glossopharyngeal neuralgia. Am J Otol 1995;16(3):326—30.Taha J.M., Tew J.M. Long-term results of surgical treatment of idiopathic neuralgias of the glossopharyngeal and vagal nerves. Neurosurgery 1995;36(5):926—30. DOI: 10.1227/00006123-199505000-00006.Taha J.M., Tew J.M. Long-term results of surgical treatment of idiopathic neuralgias of the glossopharyngeal and vagal nerves. Neurosurgery 1995;36(5):926—30. DOI: 10.1227/00006123-199505000-00006.Dandy W.E. Glossopharyngeal neuralgia (tic douloureux): its diagnosis and treatment. Arch Surg 1927;15:198—214. DOI: 10.1001/archsurg.1927.01130200046002.Dandy W.E. Glossopharyngeal neuralgia (tic douloureux): its diagnosis and treatment. Arch Surg 1927;15:198—214. DOI: 10.1001/archsurg.1927.01130200046002.Rushton J.G., Stevens J.C., Miller R.H. Glossopharyngeal (vagoglossopharyngeal) neuralgia a study of 217 cases. Arch Neurol 1981;38(4):201—5. DOI: 10.1001/archneur.1981.00510040027002.Rushton J.G., Stevens J.C., Miller R.H. Glossopharyngeal (vagoglossopharyngeal) neuralgia a study of 217 cases. Arch Neurol 1981;38(4):201—5. DOI: 10.1001/archneur.1981.00510040027002.Ferroli P., Fioravanti A., Schiariti M. et al. Microvascular decompression for glossopharyngeal neuralgia: a long-term retrospectic review of the Milan-Bologna experience in 31 consecutive cases. Acta Neurochir (Wien) 2009;151(10):1245—50. DOI: 10.1007/s00701-009-0330-5.Ferroli P., Fioravanti A., Schiariti M. et al. Microvascular decompression for glossopharyngeal neuralgia: a long-term retrospectic review of the Milan-Bologna experience in 31 consecutive cases. Acta Neurochir (Wien) 2009;151(10):1245—50. DOI: 10.1007/s00701-009-0330-5.Patel A., Kassam A., Horowitz M. et al. Microvascular decompression in the management of glossopharyngeal neuralgia: analysis of 217 cases. Neurosurgery 2002;50(4):705—10. DOI: 10.1097/00006123-200204000-00004.Patel A., Kassam A., Horowitz M. et al. Microvascular decompression in the management of glossopharyngeal neuralgia: analysis of 217 cases. Neurosurgery 2002;50(4):705—10. DOI: 10.1097/00006123-200204000-00004.Sampson J.H., Grossi P.M., Asaoka K., Fukushima T. Microvascular decompression for glossopharyngeal neuralgia: long-term effectiveness and complication neuralgia treated by microvascular avoidance. Neurosurgery 2004;54(4):884-9. DOI: 10.1227/01.neu.0000114142.98655.cc.Sampson J.H., Grossi P.M., Asaoka K., Fukushima T. Microvascular decompression for glossopharyngeal neuralgia: long-term effectiveness and complication neuralgia treated by microvascular avoidance. Neurosurgery 2004;54(4):884-9. DOI: 10.1227/01.neu.0000114142.98655.cc.Xiong N.X., Zhao H.Y., Zhang F.C., Liu R.E. Vagoglossopharyngeal decompression and glossopharyngeal rhizotomy: clinical results of 21 cases. Stereotact Funct Neurosurg 2012;90(1):45—50. DOI: 10.1159/000333828.Xiong N.X., Zhao H.Y., Zhang F.C., Liu R.E. Vagoglossopharyngeal decompression and glossopharyngeal rhizotomy: clinical results of 21 cases. Stereotact Funct Neurosurg 2012;90(1):45—50. DOI: 10.1159/000333828.

The authors declare that there are no conflicts of interest present.