The glossopharyngeal nerve, glossopharyngeal neuralgia and the Eagle's syndrome--current concepts and management.

Glossopharyngeal neuralgia is not just a painful condition. At times, it may be life-threatening as a result of associated cardiovascular consequences. Even in the absence of life-threatening consequences, it can be a severe debilitating disease with depression, suicidal tendencies, fear of swallowing, loss of weight and under-nutrition. The treatment for glossopharyngeal neuralgia and Eagle's syndrome has evolved over time. This review summarises the scientific evidence and philosophy about current management and therapy. Emphasis is placed on the importance of excluding secondary causes of glossopharyngeal neuralgia before embarking on nerve section through the posterior cranial fossa approach. The Eagle's syndrome due to an elongated styloid process is the most important cause of secondary glossopharyngeal neuralgia. Stylectomy is effective and should be considered before embarking on any neurosurgical procedure. Peripheral cervical and trans-tonsillar approaches to the glossopharyngeal nerve are also discussed.