Pain-free survival after vagoglossopharyngeal complex sectioning with or without microvascular decompression in glossopharyngeal neuralgia.
OBJECTIVEGlossopharyngeal neuralgia (GN) is a uncommon ache situation wherein sufferers expertise paroxysmal, lancinating throat ache. A number of surgical approaches have been used to deal with this situation, together with microvascular decompression (MVD), and sectioning of cranial nerve (CN) IX and the higher rootlets of CN X, or a mix of the 2. The goal of this research was to look at the long-term high quality of life and pain-free survival after MVD and sectioning of the CN X/IX complicated.METHODSA mixed retrospective chart assessment and a quality-of-life phone survey had been carried out to gather demographic and long-term consequence knowledge.
High quality of life was assessed by the use of a questionnaire based mostly on a mix of the Barrow Neurological Institute ache depth scoring standards and the Temporary Ache Stock-Facial. Kaplan-Meier evaluation was carried out to find out pain-free survival.RESULTSOf 18 sufferers with GN, 17 underwent sectioning of the CN IX/X complicated alone or sectioning and MVD relying on the presence of a compressing vessel. Eleven of 17 sufferers had compression of CN IX/X by the posterior inferior cerebellar artery, 1 had compression by a vertebral artery, and 5 had no compression.
One affected person (6%) skilled no quick ache aid. Fifteen (88%) of 17 sufferers had been ache free on the final follow-up (imply 9.33 years, vary 5.16-13 years). One affected person (6%) skilled throat ache relapse at Three months. The median pain-free survival was 7.5 years ± 10.6 months. 9 of 18 sufferers had been contacted by phone. Of the 17 sufferers who underwent sectioning of the CN IX/X complicated, 13 (77%) sufferers had short-term complaints: dysphagia (n = 4), hoarseness (n = 4), ipsilateral listening to loss (n = 4), ipsilateral style loss (n = 2), and dizziness (n = 2) at 2 weeks.
9 sufferers had persistent uncomfortable side effects at newest follow-up. Eight of 9 phone respondents reported that they might have the surgical procedure over once more.CONCLUSIONSSectioning of the CN IX/X complicated with or with out MVD of the glossopharyngeal nerve is a protected and efficient surgical remedy for GN with preliminary ache freedom in 94% of sufferers and a very good long-term ache aid (imply 7.5 years).
Transient receptor potential melastatin-Three within the rat sensory ganglia of the trigeminal, glossopharyngeal and vagus nerves.
Transient receptor potential melastatin-3 (TRPM3) is a nonselective cation channel, has permeability of Ca2+, and possibly participates in thermosensitive nociception. On this research, immunohistochemistry for TRPM3 was carried out within the rat trigeminal, glossopharyngeal and vagal sensory ganglia. TRPM3-immunoreactivity was expressed by half of sensory neurons within the trigeminal (TG), petrosal (PG) and jugular ganglia (JG), and by about 80% of sensory neurons within the nodose ganglion (NG). They principally had small to medium-sized cell our bodies.
A trichrome immunofluorescence technique confirmed co-existence of TRPM3 with TRP vanilloid 1 (TRPV1) and calcitonin gene-related peptide (CGRP). Roughly 70% of TRPM3-immunoreactive (-IR) neurons contained TRPV1-immunoreactivity in all of the examined ganglia. Greater than 40% of TRPM3-IR neurons exhibited CGRP-immunoreactivity within the TG, PG and JG. Just a few sensory neurons co-expressed TRPM3- and CGRP-immunoreactivity within the NG. As well as, greater than 40% of TRPM3-IR neurons certain to isolectin B4 in all of the examined ganglia.
By mixture of retrograde tracing technique and immunohistochemistry, half of TG neurons innervating the facial pores and skin and incisive papilla expressed TRPM3-immunoreactivity whereas roughly 20% of these innervating the tooth pulp contained TRPM3-immunoreactivity. Co-expression of TRPM3-immunoreactivity with TRPV1- or CGRP-immunoreactivity was widespread amongst cutaneous and papillary TG neurons however not amongst pulpal TG neurons.
Greater than 60% of PG and JG neurons innervating the exterior ear canal pores and skin and circumvallate papilla contained TRPM3-immunoreactivity. Co-expression of TRPM3 with TRPV1 or CGRP was widespread amongst PG and JG neurons innervating the exterior ear canal pores and skin. Nonetheless, a smaller variety of TRPM3-IR neurons co-expressing TRPV1- or CGRP-immunoreactivity innervate the circumvallate papilla within the PG. The current research means that expression of TRPM3 and its co-existence with TRPV1 and CGRP in sensory neurons depend upon the number of their peripheral targets within the trigeminal, glossopharyngeal and vagal nervous programs.
Glossopharyngeal Neuralgia with Syncope Attributable to Recurrence of Esophageal Squamous Cell Carcinoma.
We herein report a case of glossopharyngeal neuralgia with repeated syncope brought on by the recurrence of esophageal carcinoma. The everyday signs of glossopharyngeal neuralgia are paroxysmal, stabbing, electrical shock-like ache within the pharynx and/or base of the tongue on swallowing and speaking. As well as, syncope will also be brought on by glossopharyngeal neuralgia.
The prognosis of glossopharyngeal neuralgia will not be at all times simple due to its rarity. Within the current case, we suspected that repeated syncope was brought on by glossopharyngeal neuralgia as a result of recurrence of esophageal carcinoma. Concurrent chemoradiation remedy was efficient in lowering the tumor measurement, which resulted within the full decision of the signs.
Monitoring the glossopharyngeal nerve pathway by anatomical references in cross-sectional imaging strategies: a pictorial assessment.
The glossopharyngeal nerve (GPN) is a hardly ever thought-about cranial nerve in imaging interpretation, primarily as a result of medical indicators might stay unnoticed, but in addition on account of its complicated anatomy and inconspicuousness in standard cross-sectional imaging. On this pictorial assessment, we goal to conduct a complete assessment of the GPN anatomy from its origin within the central nervous system to peripheral goal organs.
As a result of the nerve can’t be visualised with standard imaging examinations for many of its course, we are going to deal with essentially the most related anatomical references alongside the complete GPN pathway, which will likely be divided into the mind stem, cisternal, cranial base (to which we are going to add the parasympathetic pathway leaving the primary trunk of the GPN on the cranial base) and cervical segments.
For that objective, we are going to make the most of cadaveric slices and dissections, our personal developed drawings and schemes, and computed tomography (CT) and magnetic resonance imaging (MRI) cross-sectional photographs from our hospital’s radiological info system and film and archiving communication system.