The cerebello-pontine angle
lipomas causing
trigeminal neuralgia or
hemifacial spasm are rare. A
lipoma causing glossopharyngel
neuralgia is also very rare. A 46-year-old woman complained of 2-year history of severe right throat
pain, with ipsilateral episodic otalgic
pain. The throat
pain was described as an episodic lancinating character confined to the throat. Computed tomography and magnetic resonance imaging revealed a suspicious offending posterior inferior cerebellar artery (
PICA) compressing lower cranial nerves including glossopharyngeal nerve. At surgery, a soft, yellowish mass (2×3×3 mm in size) was found incorporating the lateral aspect of proximal portion of 9th and 10th cranial nerves. Only
microvascular decompression of the offending
PICA was performed. Additional procedure was not performed. Her severe lancinating
pain remained unchanged, immediate postoperatively. The neuralgic
pain disappeared over a period of several weeks. In this particular patient with a fatty neurovascular lump causing
glossopharyngeal neuralgia,
microvascular decompression of offending vessel alone was enough to control the neuralgic
pain.