Neurosurg Focus 59(3):E19, 2025
Microvascular decompression (MVD) without neurectomy is effective and safe for glossopharyngeal neuralgia (GPN), with 86% long-term pain freedom and minimal complications. Pain location or radiation did not affect outcomes. Redo MVD is effective for persistent neurovascular compression. High-resolution MRI is useful for preoperative assessment.
• Microvascular decompression (MVD) without neurectomy is effective for glossopharyngeal neuralgia (GPN), including redo procedures.
• In a cohort of 29 patients, 86% were pain free at long-term follow-up (mean 65.3 months); 83% were immediately pain free post-op.
• Complication rates were low: 10% immediate and 11% long-term, with mostly mild symptoms.
• Redo MVD was successful in 3 out of 4 patients with persistent neurovascular compression after prior procedures.
• Pain location or direction of radiation did not affect pain outcomes after MVD.
• Most patients had neurovascular compression (NVC) visible on preoperative MRI, commonly involving the posterior inferior cerebellar artery (PICA).
• MVD is effective even in elderly patients and those with failed prior treatments, provided NVC is present.
• Findings support MVD as a primary treatment for classical GPN, guiding patient selection and management.
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