Glossopharyngeal neuralgia: surgical treatment and electron microscopic findings

Seven cases of idiopathic glossopharyngeal neuralgia were treated with surgical resection via pharyngeal approach. Two of these cases showed a recurrence of neuralgia and subsequently, one of the recurring cases underwent a IXth nerve section through a cervical approach. The resected nerves were examined with the light and electron microscope. In five of seven cases, degeneration of myelinated fibers was observed. Under electron microscope, disarrangement and disorganization of the myelin sheath were found, while axonal degeneration was relatively rare. The author recommends an initial resection by the pharyngeal approach. In cases of recurrence, a subsequent attempt to resect the nerve should be made by the cervical approach.