ABSTRACT
Objective To investigate the possibility of MRI on visualizing the relationship between glossopharyngeal nerve and surrounding vessels,and to evaluate the significance of MRI in the diagnosis and treatment of glossopharyngeal neuralgia.Methods MRI findings were analyzed retrospectively in 12 patients with glossopharyngeal neuralgia,and were compared with surgical findings and effect of pain relief.Results The artery compression or contact of the glossopharyngeal entry zone,as revealed during operation in l0 patients with glossopharyngeal neuralgia,was visualized on MRI in 9 and not seen in 1.The venous compression of the glossopharyngeal entry zone was not identified on MRI in 1.The conglutinative arachnoids of the glossopharyngeal entry zone was not visualized on MRI in 1.MRI demonstrated the affected glossopharyngeal nerve root entry zone was compressed or contacted by the posterior inferior cerebellar artery (PICA)in 8 patients and by the vertebral artery in 1 patient.One patient's offending vessel was confirmed to be the anterior inferior cerebellar artery(AICA)by the operation,and the surgical findings were corresponded with MRI in others.Vascular compression or contact of the affected glossopharyngeal nerve was not visualized on MRI in 3 patients,and operation confirmed that the glossopharyngeal nerve root entry zone was compressed by unknown artery in 1,by small vein in 1,and by eonglutinative araehnoids in 1, respectively.Eight patients presented with symptoms of the ipsilateral trigeminal neuralgia concurrently.The compression of the affected trigeminal nerve root by superior cerebellar artery(SCA)was visualized on MRI in 6 patients,and operation did not reveal the source of artery compression in 1 and corresponded with MRI findings in other 5 cases.Vascular compression of affected trigeminal nerve was not visualized on MRI in 2 patients,and intraoperative inspection revealed that trigeminal nerve root was compressed by draining vein of brainstem in 1 and not compressed by any vessels in 1.All patient's neuralgia resolved after microvascular decompression of glossopharyngeal nerve and trigeminal nerve.Conclusion It is possible to visualize the glossopharyngeal and surrounding arteries on MRI,and it is of great significance in the diagnosis and treatment of this kind of glossopharyngeal neuralgia.