{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:49:02Z","timestamp":1792176542487,"version":"4.4.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1991,10]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Intractable, unexplained deep-ear pain presents a rare, albeit significant problem in otolaryngological and neurosurgical practice. The authors review their experience with 18 cases of primary otalgia during the past 15 years. A total of 31 surgical procedures were performed. Seventeen patients had sequential rhizotomies and one patient had microvascular decompression alone. Based on the clinical diagnosis, the nerves sectioned were singly or in combination: the nervus intermedius (14 patients), geniculate ganglion (10 patients), ninth nerve (14 patients), 10th nerve (11 patients), tympanic nerve (four patients), and chorda tympani nerve (one patient). Microvascular decompression of the involved nerves was undertaken in nine patients, in whom vascular loops were discovered. Adhesions (six patients), thickened arachnoid (three patients), and benign osteoma (one patient) were other intraoperative abnormalities noted.<\/jats:p>\n<jats:p content-type=\"fine-print\">The overall success of these procedures in providing pain relief was 72.2%, and the mean follow-up period was 3.3 years (range 1 month to 14.5 years). There was no surgical mortality. Expected side effects were: decreased lacrimation, salivation, and taste related to nervus intermedius nerve section, and transient hoarseness and diminished gag related to ninth and 10th nerve section. Four patients developed sequelae consisting of sensorineural hearing loss, vertigo, and transient facial nerve paresis. One patient had a cerebrospinal fluid leak and another developed aseptic meningitis as postoperative complications. Except when primary glossopharyngeal neuralgia is the working diagnosis, a combined posterior cranial fossa-middle cranial fossa approach is recommended for adequate exploration and\/or section of the fifth, ninth, and 10th cranial nerves as well as the geniculate ganglion and nervus intermedius.<\/jats:p>","DOI":"10.3171\/jns.1991.75.4.0505","type":"journal-article","created":{"date-parts":[[2009,5,19]],"date-time":"2009-05-19T16:21:29Z","timestamp":1242750089000},"page":"505-511","source":"Crossref","is-referenced-by-count":58,"title":["Geniculate neuralgia: the surgical management of primary otalgia"],"prefix":"10.3171","volume":"75","author":[{"given":"Vedantam","family":"Rupa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard L.","family":"Saunders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dudley J.","family":"Weider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Acta Neurochir","first-page":"142","article-title":"Neuralgia of the intermediate nerve combined with trigeminal neuralgia: case report.","volume":"91","author":"Bellotti","year":"1988"},{"key":"b2","series-title":"Brain","first-page":"371","article-title":"Glossopharyngeal neuralgia.","volume":"85","author":"Bohm","year":"1962"},{"key":"b3","series-title":"Arch Otolaryngol","first-page":"473","article-title":"Geniculate neuralgia and facial nerve sensory systems.","volume":"103","author":"Boudreau","year":"1977"},{"key":"b4","series-title":"J Neurosurg","first-page":"299","article-title":"Glossopharyngeal neuralgia caused by compression of the nerve by an atheromatous vertebral artery.","volume":"13","author":"Brihaye","year":"1956"},{"key":"b5","series-title":"JAMA","first-page":"2144","article-title":"True tic douloureux of the sensory filaments of the facial nerve. I. Clinical report of a case in which cure was effected by physiological extirpation of the geniculate ganglion. II. Report of surgical treatment.","volume":"53","author":"Clark","year":"1909"},{"key":"b6","series-title":"J Neurosurg","first-page":"895","article-title":"Primary juvenile otalgia. Report of a case with surgical cure.","volume":"20","author":"Cooper","year":"1963"},{"key":"b7","series-title":"Arch Surg","first-page":"198","article-title":"Glossopharyngeal neuralgia (tic douloureux). Its diagnosis and treatment.","volume":"15","author":"Dandy","year":"1927"},{"key":"b8","series-title":"JAMA","first-page":"255","article-title":"Tic douloureux of the nervus intermedius (so called idiopathic geniculate neuralgia).","volume":"119","author":"Furlow","year":"1942"},{"key":"b9","series-title":"Brain","first-page":"557","article-title":"Persistent pain in lesions of the peripheral and central nervous system.","volume":"44","author":"Harris","year":"1921"},{"key":"b10","series-title":"Arch Neurol Psychiatry","first-page":"253","article-title":"Geniculate neuralgia (neuralgia of the nervus facialis). A further contribution to the sensory system of the facial nerve and its neuralgic conditions.","volume":"37","author":"Hunt","year":"1937"},{"key":"b11","series-title":"Arch Otolaryngol","first-page":"543","article-title":"Otalgia considered as an affection of the sensory system of the seventh cranial nerve.","volume":"36","author":"Hunt","year":"1907"},{"key":"b12","series-title":"Lancet","first-page":"397","article-title":"Glosso-pharyngeal neuralgia.","volume":"2","author":"Jefferson","year":"1931"},{"key":"b13","series-title":"J Neurosurg","first-page":"445","article-title":"Trigeminal neuralgia, facial spasm, intermedius and glossopharyngeal neuralgia with persistent carotid basilar anastomosis.","volume":"31","author":"Kempe","year":"1969"},{"key":"b14","series-title":"J Neurosurg","first-page":"494","article-title":"Treatment of essential neuralgia of the 9th nerve by selective tractotomy.","volume":"23","author":"Kunc","year":"1965"},{"key":"b15","series-title":"Arch Otolaryngol","first-page":"642","article-title":"Anomalous vascular lesion in the cerebellopontile angle. Severe neuralgic pain in the ear and profound nervous disturbance; operation and recovery.","volume":"23","author":"Lillie","year":"1936"},{"key":"b16","series-title":"Surg Neurol","first-page":"147","article-title":"Geniculate neuralgia and audio-vestibular disturbance due to compression of the intermediate and eighth nerves by the postero-inferior cerebellar artery.","volume":"13","author":"Ouaknine","year":"1980"},{"key":"b17","series-title":"Ann Surg","first-page":"256","article-title":"Glossopharyngeal neuralgia.","volume":"101","author":"Peet","year":"1935"},{"key":"b18","series-title":"Laryngoscope","first-page":"955","article-title":"Geniculate neuralgia: diagnosis and surgical management.","volume":"86","author":"Pulec","year":"1976"},{"key":"b19","series-title":"JAMA","first-page":"1744","article-title":"Tympanic plexus neuralgia. True tic douloureux of the ear or so-called geniculate ganglion neuralgia: cure effected by intracranial section of the glossopharyngeal nerve.","volume":"100","author":"Reichert","year":"1933"},{"key":"b20","series-title":"J Neurosurg","first-page":"609","article-title":"Nervus intermedius.","volume":"29","author":"Rhoton","year":"1968"},{"key":"b21","series-title":"Arch Neurol Psychiatry","first-page":"375","article-title":"Tic douloureux of the chorda tympani. Report of cases.","volume":"69","author":"Rosen","year":"1953"},{"key":"b22","series-title":"Arch Neurol","first-page":"201","article-title":"Glossopharyngeal (vagoglossopharyngeal) neuralgia. A study of 217 cases.","volume":"38","author":"Rushton","year":"1981"},{"key":"b23","series-title":"J Neurosurg","first-page":"54","article-title":"The role of the nervus intermedius in facial neuralgia. Report of four cases with observations on the pathways for taste, lacrimation, and pain in the face.","volume":"28","author":"Sachs","year":"1968"},{"key":"b24","series-title":"Brain","first-page":"387","article-title":"Tympanic membrane sensation.","volume":"108","author":"Saunders","year":"1985"},{"key":"b25","series-title":"Brain","first-page":"23","article-title":"The arterial relations of the internal auditory meatus.","volume":"68","author":"Sunderland","year":"1945"},{"key":"b26","series-title":"JAMA","first-page":"1600","article-title":"Cerebello-pontile tumor diagnosed for six years as tic douloureux. The symptoms of irritation of the ninth and twelfth cranial nerves.","volume":"54","author":"Weisenburg","year":"1910"},{"key":"b27","series-title":"Pain and the Neurosurgeon. A Forty-Year Experience.","first-page":"257","author":"White","year":"1969"},{"key":"b28","series-title":"J Neurosurg","first-page":"473","article-title":"Geniculate neuralgia. Report of a case relieved by intracranial section of the nerve of Wrisberg.","volume":"7","author":"Wilson","year":"1950"},{"key":"b29","series-title":"Am J Anat","first-page":"101","article-title":"The nerves and nerve endings in the membrana tympani of man.","volume":"11","author":"Wilson","year":"1911"},{"key":"b30","series-title":"Neurology","first-page":"682","article-title":"Tic convulsif, the combination of geniculate neuralgia and hemifacial spasm relieved by vascular decompression.","volume":"34","author":"Yeh","year":"1984"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/75\/4\/article-p505.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/75\/4\/article-p505.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/75\/4\/article-p505.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T22:23:31Z","timestamp":1679264611000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/75\/4\/article-p505.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,10]]},"references-count":30,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/jns.1991.75.4.0505","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1991,10]]}}}