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Paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case
BACKGROUND: Intermediate nerve neuralgia is a rare type of cranial neuralgia that causes clinical, therapeutic, and diagnostic challenges. Studies have described pharmacological and surgical treatment options. Surgical treatment ranges from sectioning of neural structures to microvascular decompress...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Association of Neurological Surgeons
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245770/ https://www.ncbi.nlm.nih.gov/pubmed/35854834 http://dx.doi.org/10.3171/CASE2155 |
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author | Witters, Leonie Lukes, Anton Menovsky, Tomas |
author_facet | Witters, Leonie Lukes, Anton Menovsky, Tomas |
author_sort | Witters, Leonie |
collection | PubMed |
description | BACKGROUND: Intermediate nerve neuralgia is a rare type of cranial neuralgia that causes clinical, therapeutic, and diagnostic challenges. Studies have described pharmacological and surgical treatment options. Surgical treatment ranges from sectioning of neural structures to microvascular decompression. Given the rareness of the disease, there are no clear recommendations concerning treatment. OBSERVATIONS: Reported is the case of a patient with typical intermediate nerve neuralgia. In this particular case, decision-making toward surgical decompression in an earlier stage of the disease could have been beneficial. The authors found excellent results using only microvascular decompression without sectioning of neural structures. LESSONS: Knowledge of intermediate nerve anatomy is essential to understand this complex pain syndrome. This case illustrates that surgery should not only be regarded as a last resort in case of failure of conservative treatment but also should be considered early in the disease course, especially in the case of a clear neurovascular conflict. When no evident cause is found, surgery could be considered as an exploratory option to depict a neurovascular conflict intraoperatively. Microvascular decompression of the intermediate nerve without sectioning of neural structures can obtain excellent results. Since neural structures are saved, postoperative sequelae can be limited. |
format | Online Article Text |
id | pubmed-9245770 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | American Association of Neurological Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-92457702022-07-18 Paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case Witters, Leonie Lukes, Anton Menovsky, Tomas J Neurosurg Case Lessons Case Lesson BACKGROUND: Intermediate nerve neuralgia is a rare type of cranial neuralgia that causes clinical, therapeutic, and diagnostic challenges. Studies have described pharmacological and surgical treatment options. Surgical treatment ranges from sectioning of neural structures to microvascular decompression. Given the rareness of the disease, there are no clear recommendations concerning treatment. OBSERVATIONS: Reported is the case of a patient with typical intermediate nerve neuralgia. In this particular case, decision-making toward surgical decompression in an earlier stage of the disease could have been beneficial. The authors found excellent results using only microvascular decompression without sectioning of neural structures. LESSONS: Knowledge of intermediate nerve anatomy is essential to understand this complex pain syndrome. This case illustrates that surgery should not only be regarded as a last resort in case of failure of conservative treatment but also should be considered early in the disease course, especially in the case of a clear neurovascular conflict. When no evident cause is found, surgery could be considered as an exploratory option to depict a neurovascular conflict intraoperatively. Microvascular decompression of the intermediate nerve without sectioning of neural structures can obtain excellent results. Since neural structures are saved, postoperative sequelae can be limited. American Association of Neurological Surgeons 2021-05-10 /pmc/articles/PMC9245770/ /pubmed/35854834 http://dx.doi.org/10.3171/CASE2155 Text en © 2021 The authors https://creativecommons.org/licenses/by-nc-nd/4.0/CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ). |
spellingShingle | Case Lesson Witters, Leonie Lukes, Anton Menovsky, Tomas Paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case |
title | Paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case |
title_full | Paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case |
title_fullStr | Paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case |
title_full_unstemmed | Paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case |
title_short | Paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case |
title_sort | paroxysmal otalgia treated with microvascular decompression of the intermediate nerve: illustrative case |
topic | Case Lesson |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245770/ https://www.ncbi.nlm.nih.gov/pubmed/35854834 http://dx.doi.org/10.3171/CASE2155 |
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