Gamma Knife Radiosurgery for Glossopharyngeal Neuralgia: A Retrospective Study

Abstract

Introduction: The treatment of patients with glossopharyngeal neuralgia (GN) refractory to medical therapies is challenging. Gamma knife radiosurgery (GKRS) has emerged as an incisionless treatment option with outcomes reported in a limited number of studies. The aim of this study was to report on the outcomes of GKRS in patients with GN treated at our center.

Methods: We retrospectively reviewed all patients with GN who underwent GKRS at our center since 2017. Pain intensity was evaluated using the Barrow Neurological Institute (BNI) pain score modified for GN. Adverse events were recorded.

Results: Six patients underwent GKRS for GN at our center between 2017 and 2024. The maximum dose delivered was 85 Gy for 1 patient and 90 Gy for the others. After a median period of 2 weeks from GKRS, all patients experienced pain reduction (BNI I-IIIa). Pain recurred during follow-up in 2 patients after 9 and 3 months, respectively. Both underwent repeat GKRS, which relieved pain in one. No adverse event or neurological deficit occurred.

Conclusions: GKRS is an effective, well-tolerated treatment for patients with GN. Pain may recur over time, but more durable pain relief can be achieved with repeat GKRS.

Keywords: Facial pain; Gamma knife; Glossopharyngeal nerve; Glossopharyngeal neuralgia; Neuropathic pain; Radiosurgery.