{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:56:13Z","timestamp":1792515373657,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T00:00:00Z","timestamp":1577318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Geniculate neuralgia (GN) is an uncommon, but severe, condition that is characterized by excruciating paroxysmal pain in the seventh cranial nerve's cutaneous distribution of general somatic afferent fibers carried through the nervus intermedius (NI). GN becomes a surgical disease in refractory cases of pain after exhaustive medical management. Surgical intervention in the form of microvascular decompression and nerve sectioning has been investigated with good patient outcomes. Despite this, there are limited guidelines on either technique's appropriateness in specific operative scenarios. In our 30\u2010year experience in GNs surgical management, we have found that a detailed knowledge of the NIs anatomy, variants, and intraoperative surgical anatomic findings are the key to choosing the most appropriate intervention, and may provide the answer to why some patients fail to experience pain relief after surgery. These anatomic variants also may explain why many patients commonly do not experience side effects related to the visceral efferent and special afferent fibers after nerve sectioning.<\/jats:p>","DOI":"10.1002\/ca.23536","type":"journal-article","created":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T11:55:35Z","timestamp":1576324535000},"page":"1056-1061","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinical implications of nervus intermedius variants in patients with geniculate neuralgia: Let anatomy be the guide"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3533-8776","authenticated-orcid":false,"given":"William E.","family":"Clifton","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4307-7062","authenticated-orcid":false,"given":"Sanjeet","family":"Grewal","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry","family":"Lundy","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William P.","family":"Cheshire","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1317-1047","authenticated-orcid":false,"given":"R. Shane","family":"Tubbs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Structural and Cellular Biology Tulane University School of Medicine  New Orleans Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Wharen","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-012-1359-4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-013-1952-1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aanat.2010.02.004"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2013.01.076"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2338"},{"key":"e_1_2_7_7_1","first-page":"1072","article-title":"Cranial neuralgias","volume":"21","author":"Cheshire W. P.","year":"2015","journal-title":"Continuum (Minneapolis, Minnesota)"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200205000-00028"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2012.05.011"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.3.JNS172495"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2013.04.009"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1993.01090120115031"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.05.036"},{"key":"e_1_2_7_14_1","first-page":"512","article-title":"Surgical management of geniculate neuralgia","volume":"18","author":"Lovely T. J.","year":"1997","journal-title":"The American Journal of Otology"},{"issue":"2","key":"e_1_2_7_15_1","first-page":"421","article-title":"Communication between the facial and auriculotemporal nerves","volume":"185","author":"Namking M.","year":"1994","journal-title":"Journal of Anatomy"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0021-8782.2004.00313.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.3.JNS172920"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197607000-00008"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1968.29.6.0609"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1991.75.4.0505"},{"key":"e_1_2_7_21_1","first-page":"470","article-title":"Geniculate ganglion: Anatomic study with surgical implications","volume":"13","author":"Rupa V.","year":"1992","journal-title":"The American Journal of Otology"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215110002677"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947007900514"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22340"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-015-1571-z"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22067"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2012.03.023"},{"key":"e_1_2_7_28_1","volume-title":"Observationes anatomicae de quinto pare nervorum endephali et de nervis qui ex eodem duram matrem ingredi falso dicuntur","author":"Wrisberg H.","year":"1777"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fca.23536","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23536","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ca.23536","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23536","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T04:30:41Z","timestamp":1693888241000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.23536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,26]]},"references-count":27,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1002\/ca.23536"],"URL":"https:\/\/doi.org\/10.1002\/ca.23536","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"value":"0897-3806","type":"print"},{"value":"1098-2353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,26]]},"assertion":[{"value":"2019-11-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}