To investigate the efficacy of microvascular decompression (MVD) in the treatment of primary glossopharyngeal neuralgia (GN).

Forty-one patients with GN who underwent MVD from October 2007 to December 2020 in the Neurosurgery Center of the First Affiliated Hospital of Xinjiang Medical University were included. Among them, only 38 cases were treated with MVD, and 3 cases of them were treated with MVD combined with rhizotomy of glossopharyngeal nerve root and upper 1^st root filament of vagus nerve, the therapeutic effects and postoperative complications were observed. The average follow-up period was 6.3 years. From February 2018 to December 2020, 221 patients with hemifacial spasm (HFS) were treated by MVD in our hospital. The microanatomic relationship between glossopharyngeal nerve and blood vessel, glossopharyngeal nerve root and vagus nerve root filament were observed.

All the pain disappeared immediately after operation in 29 GN patients; the pain of 12 patients was obviously reduced, and the pain disappeared after 2-3 d. At the end of follow-up, 2 patients had pain recurrence, and the cure rate was 95.1%. Combined with exploration observation of 221 HFS patients with MVD, there were 4 types of anatomical relationship between glossopharyngeal nerve root and vagus nerve root filament. The gap between the glossopharyngeal nerve root and the first upper vagus nerve root was large and there was no traffic branch between them. The gap between the two was small and there was no traffic branch. The gap between the two was small and there was a traffic branch; There was no gap between the two.

MVD can be used as the preferred surgical treatment for GN, combined with glossopharyngeal nerve root and upper root filamentectomy of the vagus nerve root can provide effective treatment for GN. The surgical method should be determined according to whether or not the responsible vessel is compressed and the condition of compression.