Geniculate neuralgia: modern management
Abstract
An uncommon cause of otalgia is geniculate neuralgia. In its most typical form it is characterized by severe paroxysmal neuralgic pain centered directly in the ear. The pain may be of a gradual onset and of a dull, persistent nature, with occasional sharp, stabbing pain. When the pain becomes intractable, an operation to surgically excise the nervus intermedius and geniculate ganglion by the middle cranial fossa approach is indicated. The author has performed this surgery for 97 patients. The purpose of this paper is to review the diagnostic features of geniculate neuralgia and to describe the surgical technique for excision of the nervus intermedius and geniculate ganglion without the production of facial paralysis. This procedure is an effective, specific definitive treatment for intractable geniculate neuralgia.