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      Neuralgia del nervio glosofaríngeo posamigdalectomía. Reporte de dos casos Translated title: Post-tonsillectomy glossopharyngeal nerve neuralgia. Report of two cases

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          Abstract

          Resumen La amigdalectomía es uno de los procedimientos quirúrgicos más frecuentes que realiza el otorrinolaringólogo. Dentro de las complicaciones posoperatorias, la neuralgia del nervio glosofaríngeo es extremadamente poco frecuente. En este artículo se presentan dos casos clínicos pediátricos con neuralgia del glosofaríngeo posamigdalectomía que fueron resueltos con tratamiento médico.

          Translated abstract

          Abstract Tonsillectomy is one of the most common procedures done by the otolaryngologist. Among post-operative complications, the glossopharyngeal neuralgia is extremely uncommon. This article presents two pediatric clinical cases with post-tonsillectomy glossopharyngeal neuralgia that were resolved with medical treatment.

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          Most cited references15

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          Neuralgia of the Glossopharyngeal Nerve in a Patient with Posttonsillectomy Scarring: Recovery after Local Infiltration of Procaine—Case Report and Pathophysiologic Discussion

          L. Fischer, S. Ludin, K. Puente de la Vega … (2015)
          We describe a patient with a three-year history of severe progressive left-sided glossopharyngeal neuralgia (GPN) that failed to adequately respond to various drug therapies. The application of lidocaine spray to the posterior pharyngeal wall provided no more than short-term relief. Apart from a large hypertrophic tonsillectomy scar on the left side all clinical and radiologic findings were normal. In terms of therapeutic local anaesthesia, the hypertrophic tonsillectomy scar tissue was completely infiltrated with the local anaesthetic (LA) procaine 1%. The patient has been almost completely pain-free ever since, and the lidocaine spray is no longer needed. Six weeks after the first treatment a repeat infiltration of the tonsillectomy scar led to the complete resolution of all symptoms. The patient has become totally symptom-free without the need to take any medication now for two and a half years. This is the first report of a successful therapeutic infiltration of a tonsillectomy scar using an LA in a patient with GPN that has been refractory to medical treatment for several years. A possible explanation may be that the positive feedback loop maintaining neurogenic inflammation is disrupted and “sympathetically maintained pain” resolved by LA infiltration.
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            Treatments of glossopharyngeal neuralgia: towards standard procedures.

            Andrea Franzini, Giuseppe Messina, Angelo Franzini … (2017)
            The degree of disability due to glossopharyngeal neuralgia (GN) refractory to conservative treatments justifies surgical procedures as second-line treatments. Since the first description of this facial pain disorders, many surgical options have been described either via a percutaneous or an open surgical way. Actually, when a neurovascular conflict on root entry zone (REZ) or cisternal portion of the ninth and tenth cranial nerves is identified, microvascular decompression (MVD) is the first surgical option to consider. Many studies have demonstrated its efficacy and safety for the treatment of GN. Recently, stereotactic radiosurgery has gained space in the treatment of selected cases of GN. We provide an overview of the surgical procedures for the treatment of GN and of our own experience.
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              Bilateral glossopharyngeal nerve paralysis after tonsillectomy: case report and anatomic study.

              Mandy L. Ford, Melissa R. Cruz (2004)
              To present a case report and to propose an anatomic explanation for a rare complication of tonsillectomy, severe dysphagia caused by bilateral paralysis of the glossopharyngeal nerve. Retrospective case review and prospective cadaveric dissection. The medical record and radiologic data were reviewed from a patient who had severe dysphagia after tonsillectomy. In addition, 10 formalin-preserved cadaver head and neck specimens were dissected to identify the anatomic course of 20 glossopharyngeal nerves. The distance between the nerve and tonsillar fossa was measured at two sites. The patient was diagnosed with bilateral paralysis of the glossopharyngeal nerve and required use of gastrotomy tube for years postoperatively. The mean distance from the posterosuperior tonsillar fossa and the main trunk of the glossopharyngeal nerve was 10.7 mm, and the mean distance from the posteroinferior tonsillar fossa and the closest lingual branch of the glossopharyngeal nerve was 6.5 mm. Direct nerve injury seems the most plausible explanation for this rare complication of tonsillectomy. The proximity of the glossopharyngeal nerve to the tonsillar fossa emphasizes the importance of maintaining the correct surgical plane during surgery.
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                Author and article information

                Journal
                Journal ID (publisher-id): orl
                Title: Revista de otorrinolaringología y cirugía de cabeza y cuello
                Abbreviated Title: Rev. Otorrinolaringol. Cir. Cabeza Cuello
                Publisher: Sociedad Chilena de Otorrinolaringología, Medicina y Cirugía de Cabeza y Cuello (Santiago, , Chile )
                ISSN (Electronic): 0718-4816
                Publication date (Print and electronic): June 2022
                Volume: 82
                Issue: 2
                Pages: 195-198
                Affiliations
                [4] Santiago orgnameClínica Alemana de Santiago orgdiv1Unidad de Cuidados Intensivos Pediátricos Chile
                [5] Santiago Santiago de Chile orgnameUniversidad del Desarrollo orgdiv1Escuela de Medicina Chile
                [1] Santiago orgnameClínica Alemana de Santiago orgdiv1Departamento de Otorrinolaringología Chile
                [2] Santiago Santiago de Chile orgnameUniversidad del Desarrollo orgdiv1Facultad de Medicina Clínica Alemana Chile
                [3] Santiago orgnameClínica Alemana de Santiago orgdiv1Departamento de Anestesiología Chile
                Article
                Publisher ID: S0718-48162022000200195 Publisher ID: S0718-4816(22)08200200195
                SO-VID: e0ab2329-058b-4d71-9134-a93b724e98e0
                License:

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                Date received : 14 June 2021
                Date accepted : 16 October 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 4
                Product

                SciELO Chile

                Categories
                Subject: CASOS CLÍNICOS

                Keywords: complicaciones posoperatorias,tonsilectomía,enfermedades del nervio glosofaríngeo,neuralgia,tonsillectomy,postoperative complications,glossopharyngeal nerve diseases
                Data availability:
                Keywords: complicaciones posoperatorias, tonsilectomía, enfermedades del nervio glosofaríngeo, neuralgia, tonsillectomy, postoperative complications, glossopharyngeal nerve diseases

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