Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Lipoma Causing Glossopharyngeal Neuralgia : A Case Report and Review of Literature

  • Choi, Mi Sun (Department of Neurosurgery, Ajou University School of Medicine) ;
  • Kim, Young Im (Department of Neurosurgery, Ajou University School of Medicine) ;
  • Ahn, Young Hwan (Department of Neurosurgery, Ajou University School of Medicine)
  • Received : 2014.01.02
  • Accepted : 2014.08.14
  • Published : 2014.08.28
Download PDF
⟨ Previous Next ⟩

Abstract

The cerebello-pontine angle lipomas causing trigeminal neuralgia or hemifacial spasm are rare. A lipoma causing glossopharyngel neuralgia is also very rare. A 46-year-old woman complained of 2-year history of severe right throat pain, with ipsilateral episodic otalgic pain. The throat pain was described as an episodic lancinating character confined to the throat. Computed tomography and magnetic resonance imaging revealed a suspicious offending posterior inferior cerebellar artery (PICA) compressing lower cranial nerves including glossopharyngeal nerve. At surgery, a soft, yellowish mass ($2{\times}3{\times}3mm$ in size) was found incorporating the lateral aspect of proximal portion of 9th and 10th cranial nerves. Only microvascular decompression of the offending PICA was performed. Additional procedure was not performed. Her severe lancinating pain remained unchanged, immediate postoperatively. The neuralgic pain disappeared over a period of several weeks. In this particular patient with a fatty neurovascular lump causing glossopharyngeal neuralgia, microvascular decompression of offending vessel alone was enough to control the neuralgic pain.

Keywords

References

  1. Alafaci C, Salpietro FM, Puglisi E, Tripodo E, Matalone D, Di Pietro G : Trigeminal pain caused by a cerebellopontine-angle lipoma. Case report and review of the literature. J Neurosurg Sci 45 : 110-113, 2001
  2. Barajas RF Jr, Chi J, Guo L, Barbaro N : Microvascular decompression in hemifacial spasm resulting from a cerebellopontine angle lipoma : case report. Neurosurgery 63 : E815-E816; discussion E816, 2008 https://doi.org/10.1227/01.NEU.0000325734.30302.97
  3. Brodsky JR, Smith TW, Litofsky S, Lee DJ : Lipoma of the cerebellopontine angle. Am J Otolaryngol 27 : 271-274, 2006 https://doi.org/10.1016/j.amjoto.2005.11.002
  4. Jannetta PJ : Treatment of trigeminal neuralgia by suboccipital and transtentorial cranial operations. Clin Neurosurg 24 : 538-549, 1977 https://doi.org/10.1093/neurosurgery/24.CN_suppl_1.538
  5. Kato T, Sawamura Y, Abe H : Trigeminal neuralgia caused by a cerebellopontine-angle lipoma : case report. Surg Neurol 44 : 33-35, 1995 https://doi.org/10.1016/0090-3019(95)00056-9
  6. Kawashima M, Matsushima T, Inoue T, Mineta T, Masuoka J, Hirakawa N : Microvascular decompression for glossopharyngeal neuralgia through the transcondylar fossa (supracondylar transjugular tubercle) approach. Neurosurgery 66 (6 Suppl Operative) : 275-280; discussion 280, 2010
  7. Kondo A : Follow-up results of using microvascular decompression for treatment of glossopharyngeal neuralgia. J Neurosurg 88 : 221-225, 1998 https://doi.org/10.3171/jns.1998.88.2.0221
  8. Moretti R, Torre P, Antonello RM, Bava A, Cazzato G : Gabapentin treatment of glossopharyngeal neuralgia : a follow-up of four years of a single case. Eur J Pain 6 : 403-407, 2002 https://doi.org/10.1016/S1090-3801(02)00026-5
  9. Mukherjee P, Street I, Irving RM : Intracranial lipomas affecting the cerebellopontine angle and internal auditory canal : a case series. Otol Neurotol 32 : 670-675, 2011 https://doi.org/10.1097/MAO.0b013e31821179e0
  10. Patel A, Kassam A, Horowitz M, Chang YF : Microvascular decompression in the management of glossopharyngeal neuralgia : analysis of 217 cases. Neurosurgery 50 : 705-710; discussion 710-711, 2002 https://doi.org/10.1097/00006123-200204000-00004
  11. Resnick DK, Jannetta PJ, Bissonnette D, Jho HD, Lanzino G : Microvascular decompression for glossopharyngeal neuralgia. Neurosurgery 36 : 64-68; discussion 68-69, 1995 https://doi.org/10.1227/00006123-199501000-00008
  12. Stanic S, Franklin SD, Pappas CT, Stern RL : Gamma knife radiosurgery for recurrent glossopharyngeal neuralgia after microvascular decompression. Stereotact Funct Neurosurg 90 : 188-191, 2012 https://doi.org/10.1159/000338089
  13. Stieber VW, Bourland JD, Ellis TL : Glossopharyngeal neuralgia treated with gamma knife surgery : treatment outcome and failure analysis. Case report. J Neurosurg 102 Suppl : 155-157, 2005 https://doi.org/10.3171/jns.2005.102.s_supplement.0155
  14. White JR, Carlson ML, Van Gompel JJ, Neff BA, Driscoll CL, Lane JI, et al. : Lipomas of the cerebellopontine angle and internal auditory canal : Primum Non Nocere. Laryngoscope 123 : 1531-1536, 2013 https://doi.org/10.1002/lary.23882
  15. Yilmaz N, Unal O, Kiymaz N, Yilmaz C, Etlik O : Intracranial lipomas--a clinical study. Clin Neurol Neurosurg 108 : 363-368, 2006 https://doi.org/10.1016/j.clineuro.2005.04.003
  16. Yomo S, Arkha Y, Donnet A, Regis J : Gamma Knife surgery for glossopharyngeal neuralgia : report of 2 cases. J Neurosurgery 110 : 559-563, 2009 https://doi.org/10.3171/2008.8.17641
  17. Zimmermann M, Kellermann S, Gerlach R, Seifert V : Cerebellopontine angle lipoma : case report and review of the literature. Acta Neurochir (Wien) 141 : 1347-1351, 1999 https://doi.org/10.1007/s007010050440

Cited by

  1. Bioglue-Coated Teflon Sling Technique in Microvascular Decompression for Hemifacial Spasm Involving the Vertebral Artery vol.59, pp.5, 2014, https://doi.org/10.3340/jkns.2016.59.5.505
  2. Microvascular Decompression for Glossopharyngeal Neuralgia : Clinical Analyses of 30 Cases vol.60, pp.6, 2014, https://doi.org/10.3340/jkns.2017.0506.010
  3. A Case of Vago-Glossopharyngeal Neuralgia Caused by Choroid Plexus vol.13, pp.2, 2014, https://doi.org/10.4103/1793-5482.180890