[Nervus intermedius sectioning via the retrosigmoid approach for the treatment of nervus intermedius neuralgia: a report of 10 cases and literature review].

To explore the clinical characteristics and long-term prognosis of nervus intermedius sectioning via a retrosigmoid approach for the treatment of nervus intermedius neuralgia (NIN). A total of 10 NIN patients treated at the First Affiliated Hospital of Fujian Medical University between May 2016 and October 2024 were included retrospectively. All patients underwent nervus intermedius sectioning through the retrosigmoid approach, with combined microvascular decompression (MVD) performed for those with concomitant trigeminal neuralgia (TN) or glossopharyngeal neuralgia (GN) based on intraoperative findings. Surgical efficacy was evaluated using the Barrow Neurological Institute (BNI) Pain Intensity Score, with a follow-up period of 14-109 months. Among the 10 patients [3 males, 7 females; mean age: (58.7±11.5) years; median disease duration: 3.0 years], pain was predominantly electric shock-like (6 cases, 60.0%) and stabbing (3 cases, 30.0%). Beyond typical deep ear pain (6 cases, 60.0%), pain also involved the periauricular area (4 cases, 40.0%), cheek (2 cases, 20.0%), root of tongue (1 cases, 10.0%) and 2/3 of the tongue (1 case, 10.0%). Intraoperative exploration identified offending vessels in 7 cases (anterior inferior cerebellar artery in 5 cases and posterior inferior cerebellar artery in 2 cases). The immediate postoperative efficacy rate (BNI Ⅰ-Ⅱ) was 90.0% (9/10). Over a mean follow-up period of (61.5±31.8) months, the long-term efficacy rate at the last follow-up was 70.0% (7/10). Complications included facial paralysis, taste impairment, and wound infection in 1 case each, with no instances of hearing loss or intracranial infection. Nervus intermedius sectioning is an effective treatment for NIN with a high immediate relief rate, although a certain risk of long-term recurrence remains. For patients with concomitant cranial neuralgias, nervus intermedius sectioning combined MVD can enhance overall therapeutic outcomes.