Keisuke Onoda*, Ichiro Nakazato, Ryohei Sashida, Yu Hirokawa, Ren Fujiwara, Tomihiro Wakamiya, Yuhei Michiwaki, Tatsuya Tanaka, Kazuaki Shimoji, Eiichi Suehiro, Fumitaka Yamane, Masatou Kawashima and Akira Matsuno

Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Narita, Chiba, Japan

*Corresponding Author: Keisuke Onoda, Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Hospital, Narita, Chiba, Japan.

Received: October 07, 2022; Published: December 20, 2022

Abstract

Intermediate nerve neuralgia (INN), a relatively rare disease, is caused by vascular compression of the intermediate nerve. The main symptoms include pain in the external auditory canal, which may be accompanied by lacrimation and taste disturbance. Recently, surgery has been performed using microvascular decompression. We report a case of a 30-year-old female patient who presented with paroxysmal electric shock pain in the external auditory canal lesion. The MRI showed no vessel compression on the trigeminal nerve but the vessels ran between the facial nerve and the vestibulocochlear nerve, suggesting intermediate nerve compression. Surgery was performed with a diagnosis of INN. Intraoperative findings showed that the intermediate nerve was transected as the displacement of the responsible blood vessel would cause stretching of the internal auditory artery exiting the vessel compressing the intermediate nerve, resulting in hearing loss. Paroxysmal electric pain in the external auditory canal disappeared without the appearance of new postoperative neurological deficits.
Three-dimensional magnetic resonance cisternogram/magnetic resonance angiogram fusion images were helpful in surgical decision-making. In some cases, vascular displacement may be unsafe and difficult, and intermediate nerve transection should be considered in the procedure.

Keywords: Intermediate Nerve Neuralgia; Neurectomy; Microvascular Decompression; Magnetic Resonance Imaging

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Citation

Citation: Keisuke Onoda., et al. “A Case of Intermediate Nerve Neuralgia with a Successful Outcome with Neurectomy". Acta Scientific Neurology 6.1 (2023): 54-57.

Copyright

Copyright: © 2023 Keisuke Onoda., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.