• Journal of Life Science
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• v.23 no.12
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• pp.1541-1552
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• 2013

The purpose of this study was to investigate the structure and secretory function of the von Ebner's gland in parasympathetic or sympathetic nerve innervation. Sprague Dawley rats were sacrificed 3, 7, 10, 14, and 21 days after bilateral glossopharyngeal or hypoglossal nerve axotomy, respectively. The circumvallate papilla portion of the tongue was dissected and we observed morphological changes in the von Ebner's gland. The properties of glycoconjugate in the von Ebner's gland were investigated using nine biotinylated lectins (PSA, UEA I, GSL I $B_4$, ECL, DBA, SBA, HPA, SJA, or sWGA). Compared with the control group, cytoplasmic vacuoles appeared in the serous acini of the von Ebner's gland in the 3-day group, and the serous acini were significantly vacuolized and degenerated in the 10-day group after glossopharyngeal nerve axotomy. However, the structure of the von Ebner's gland did not change after hypoglossal nerve axotomy. In the control group, the von Ebner's glands secreted glycoconjugates containing ${\alpha}$-D-galactose, N-acetyl-D-galactosamine, and N-acetyl-D-glucosamine oligomer, and the amount of the secretion decreased significantly in the 10-day group after glossopharyngeal nerve axotomy. However, the amount of the glycoconjugate secretion did not change after hypoglossal nerve axotomy. Therefore, the results of this study suggest that the glossopharyngeal nerve containing parasympathetic nerve fibers is important for maintaining the structure of and secretory function in the von Ebner's gland in rats.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.28 no.2
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• pp.102-111
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• 2015

Objective : This study reports the effect of Korean medicine on one case diagnosed as idiopathic glossopharyngeal neuralgia. Methods : We experienced one case with idiopathic glossopharyngeal neuralgia treated with acupuncture, herbal medicine and gargling. Associated symtoms had been estimated with change of VAS(Visual Analogue Scale), severity of dysphagia, and diet type. Result : After the treatment, symptoms were decreased and almost disappered. In this case, VAS and severity of dysphagia decreased from 10 to 1 and from severe to subsided, and diet type changed from unable to DD4(Dysphagic Diet 4) during 21 days. Conclusion : This study suggests that Korean medicine is effective on idiopathic glossopharyngeal neuralgia.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.119-122
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• 1999

Glossopharyngeal neuralgia is a rare syndrome that involves episodic bursts of pain in the sensory distributuion of the ninth cranial nerve. The nature of the pain is characterized by excruciating shock-like pain in the region of the tonsillar fossa or pharynx and can radiate to the ear or the angle of the jaw. Like trigeminal neuralgia, glossopharyngeal neuralgia typically responds to anticonvulsant agents such as carbamazepine. However, dose of carbamazepine needs to be increased gradually to avoid side effects. If the patient can not tolerate until effective carbamazepine level is reached, phenytoin can be administered intravenously at the same time that oral carbamazepine therapy is begun. We present fifty-three year old female patient suffering from glossopharyngeal neuralgia who did not respond to initial carbamazepine therapy, but responded to concomitant intravenous infusion of phenytoin.

• Journal of Acupuncture Research
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• v.39 no.3
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• pp.229-233
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• 2022

Glossopharyngeal neuralgia is a skin-sensitive condition/disease that causes severe pain in the facial area predominantly innervated by the glossopharyngeal nerve. A 51-year-old man diagnosed with glossopharyngeal neuralgia who was hospitalized with severe pain that limited his daily life activities. From November 18, 2021, to March 4, 2022, he received inpatient (10 days) and outpatient treatment (35 times) using acupuncture, pharmacopuncture, and herbal medicine. His symptoms were assessed using the Numerical Rating Scale, Neuropathic Pain Scale, and the Self-report Leeds Assessment of Neuropathic Symptom and Signs. The pain reduced after 4 days of initiating Korean medicine treatment and was completely resolved within 4 months of treatment (Numerical Rating Scale score 4 to 0; Neuropathic Pain Scale score 49 to 8; Self-report Leeds Assessment of Neuropathic Symptoms and Signs score 18 to 0). Korean medicine treatment could be an option for treating patients with neuropathy who rely on analgesics.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.738-748
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• 2017

Objective : We present our experience of microvascular decompression (MVD) for glossopharyngeal neuralgia (GPN) and evaluate the postoperative outcomes in accordance with four different operative techniques during MVD. Methods : In total, 30 patients with intractable primary typical GPN who underwent MVD without rhizotomy and were followed for more than 2 years were included in the analysis. Each MVD was performed using one of four different surgical techniques : interposition of Teflon pieces, transposition of offending vessels using Teflon pieces, transposition of offending vessels using a fibrin-glue-coated Teflon sling, and removal of offending veins. Results : The posterior inferior cerebellar artery was responsible for neurovascular compression in 27 of 30 (90%) patients, either by itself or in combination with other vessels. The location of compression on the glossopharyngeal nerve varied; the root entry zone (REZ) only (63.3%) was most common, followed by both the REZ and distal portion (26.7%) and the distal portion alone (10.0%). In terms of detailed surgical techniques during MVD, the offending vessels were transposed in 24 (80%) patients, either using additional insulation, offered by Teflon pieces (15 patients), or using a fibrin glue-coated Teflon sling (9 patients). Simple insertion of Teflon pieces and removal of a small vein were also performed in five and one patient, respectively. During the 2 years following MVD, 29 of 30 (96.7%) patients were asymptomatic or experienced only occasional pain that did not require medication. Temporary hemodynamic instability occurred in two patients during MVD, and seven patients experienced transient postoperative complications. Neither persistent morbidity nor mortality was reported. Conclusion : This study demonstrates that MVD without rhizotomy is a safe and effective treatment option for GPN.

• Journal of Korean Neurosurgical Society
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• v.66 no.1
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• pp.12-23
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• 2023

Glossopharyngeal neuralgia (GPN) is a rare disease that must be differentiated from trigeminal neuralgia. The purpose of this article is to provide a comprehensive review of anatomy, pathophysiology, diagnostic criteria, and several options of treatment for GPN. Lessons learned through our experience of treating GPN are presented in detail, as well as cases of misdiagnosis and diagnostic pitfalls. Microvascular decompression (MVD) should be primarily considered for medically intractable GPN. Techniques employed in MVD for GPN are categorized and described. Especially, we underscore the advantages of the 'transposition' technique where insulating material is positioned 'off' the root entry zone (REZ), instead of 'on' it. We believe this 'off-the-REZ' technique can fundamentally prevent recurrence, if applicable. In addition, Gamma Knife radiosurgery can be an alternative option when a patient is ineligible for MVD, though it is categorized as a destructive procedure.

• The Korean Journal of Pain
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• v.35 no.3
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• pp.250-260
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• 2022

Background: Cranial nerve ganglia, which are prone to viral infections and tumors, are located deep in the head, so their detailed anatomy is difficult to understand using conventional cadaver dissection. For locating the small ganglia in medical images, their sectional anatomy should be learned by medical students and doctors. The purpose of this study is to elucidate cranial ganglia anatomy using sectioned images and three-dimensional (3D) models of a cadaver. Methods: One thousand two hundred and forty-six sectioned images of a male cadaver were examined to identify the cranial nerve ganglia. Using the real color sectioned images, real color volume model having a voxel size of 0.4 × 0.4 × 0.4 mm was produced. Results: The sectioned images and 3D models can be downloaded for free from a webpage, anatomy.dongguk.ac.kr/ganglia. On the images and model, all the cranial nerve ganglia and their whole course were identified. In case of the facial nerve, the geniculate, pterygopalatine, and submandibular ganglia were clearly identified. In case of the glossopharyngeal nerve, the superior, inferior, and otic ganglia were found. Thanks to the high resolution and real color of the sectioned images and volume models, detailed observation of the ganglia was possible. Since the volume models can be cut both in orthogonal planes and oblique planes, advanced sectional anatomy of the ganglia can be explained concretely. Conclusions: The sectioned images and 3D models will be helpful resources for understanding cranial nerve ganglia anatomy, for performing related surgical procedures.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.149-151
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• 2014

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.

• Journal of Korean Neurosurgical Society
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• v.49 no.5
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• pp.284-286
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• 2011

Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.

• The Korean Journal of Physiology
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• v.21 no.2
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• pp.313-321
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• 1987

To investigate whether the cervical sympathetics contains specific secretory fibers for the salivary glands, reflex salivation was evoked and the role of the sympathetics or the reflex was examined in ketamine-anesthetized cat. Stimulation of the central end of the glossopharyngeal nerve produced a copious secretion from the submaxillary gland and the response was not affected by the section of the cervical sympathetics or by the administration of phenoxybenzamine, whereas the response was abolished by severing the chorda tympani or by the administration of atropine. The salivary response was always associated with an increase in glandular blood flow. Both salivary and blood flow responses were decreased markedly by the superimposed stimulation of the cervical sympathetics or by the administration of norepinephrine. The decreased submaxillary blood flow always preceded the decrease in salivary flow on stimulation of the cervical sympathetics and the decreased blood flow recovered prior to the salivary flow upon cessation of the sympathetic stimulation. The inhibitory effects of the sympathetics and norepinephrine were completely abolished by the pretreatment with phenoxybenzamine. These results indicate that the glossopharyngeal nerve is one of the afferent limbs of the submaxillary salivary reflex and the chorda tympani is the only efferent limb of the reflex pathway. Thus, it is suggested that the cervical sympathetics does not contain the specific secretory fibers for the gland, but plays a role in inhibiting the reflex secretion by decreasing the blood flow to the gland.