Medical insurance coverage of radiosurgery for glossopharyngeal neuralgia in Korea

Abstract

Glossopharyngeal neuralgia (GPN) is a cranial nerve rhizopathic disorder that presents as extreme neuralgic pain in the ipsilateral deep throat, tongue base, or ear. Attacks of pain are usually intense and electric shock-like, occurring either without warning or triggered by swallowing. GPN is roughly estimated to account for 1% of trigeminal neuralgia cases. Microvascular decompression (MVD) surgery for GPN is still challenging, but it can be a safe and efficient option, with an over 90% cure rate for neuralgic pain. However, the glossopharyngeal or vagus nerves are composed of thin and vulnerable bundles of fine fibers, making them sensitive to surgical manipulation, such as traction or compression. Disastrous side effects such as permanent swallowing difficulty, respiration difficulty, or fatal cardiac arrhythmia could occur during or after surgery. Furthermore, MVD may not be a suitable treatment option for elderly patients or those with serious medical conditions. Gamma Knife radiosurgery for patients with GPN has recently been covered by national medical insurance, in Korea.