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Updated: Oct 8, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Long-term outcomes of microvascular decompression vs neurotomy for glossopharyngeal neuralgia: a multicenter
José D Carrillo-Ruiz1,2,3, Carlos Barzallo-Sacoto4, Álvaro Diego Rivera-Arroyo5
1Functional and Stereotactic Neurosurgery Service, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico.
Introduction:
Glossopharyngeal neuralgia (GPN) is a rare cranial pain syndrome, with limited comparative long-term evidence for microvascular decompression (MVD) and neurotomy (NT).
Objectives:
To compare clinimetric outcomes of microvascular decompression (MVD) and neurotomy (NT) in patients with glossopharyngeal neuralgia (GPN).
Methods:
Analytical ambispective multicenter study (1990-2024) including patients with GPN treated with MVD or NT across 3 international neurosurgical centers. Pharmacological treatment history was recorded. Pain intensity was assessed pre- and postoperatively using the Visual Analog Scale (VAS) and Barrow Neurological Institute-Pain Intensity Score. Positive sensory symptoms (PSS) including allodynia, dysesthesia, and paresthesia were evaluated when data were available.
Results:
From a total of 93 medical records, 25 patients underwent surgery; 23 met inclusion criteria (MVD = 12, NT = 11) and were evaluated long-term. Patients had a mean age of 58.48 ± 14.33 years, and follow-up ranged from 6 months to 14 years (mean 5.2 ± 4.52). All patients were refractory to pharmacotherapy. Overall VAS scores decreased from 4 to 10 (mode 10) preoperatively to 0 to 5 (mode 0) postoperatively (P = 2.38 × 10-7). In the MVD group, VAS decreased from 4 to 10 to 0 to 5 (P = 0.00049), and in the NT group from 8 to 10 to 0 to 4 (P = 0.00098), with no significant difference in postoperative scores between groups (P = 0.913). Positive sensory symptoms were assessed in 12 patients (52.17%); 9 (75%) presented ≥1 preoperatively (100% allodynia, 77.8% dysesthesia, 22.2% paresthesia). Postoperatively, only 1 patient (8.3%) had persistent dysesthesia and paresthesia.
Conclusions:
Both MVD and NT are highly effective in reducing pain and PSS in GPN, with comparable postoperative outcomes. Limitations include small sample size and ambispective design.
