Abstract：
Glossopharyngeal neuralgia due to vertebrobasilar dolichoectasia is a rare form of neuropathic pain, and presents diagnostic and therapeutic challenges. Clinical presentation: A 67-year-old man presented with severe burning pain in the left oral cavity, with no explanatory findings during dental and ear, nose, and throat evaluations. Temporomandibular joint examination revealed tenderness, and panoramic radiographs showed a noncontributory periapical radiolucency. Magnetic resonance imaging/magnetic resonance angiography revealed abnormally tortuous vertebral arteries compressing the glossopharyngeal nerves and the brainstem. Topical lidocaine reduced pain, confirming glossopharyngeal neuralgia. Carbamazepine was initially ineffective, but at 200 mg pain reduced from 90 to 20 on the visual analog scale. The patient requested and underwent microvascular decompression surgery, which eliminated his pain. Conclusion: When the vertebral artery compresses the glossopharyngeal nerve, the pain is more intense, attributed to its thicker vascular structure. Local anesthetic testing aids in identifying glossopharyngeal neuralgia. Dental practitioners must be skilled in diagnostics and possess anatomical knowledge for accurate evaluation and referral of throat and ear pain.
摘要：
背景：由椎基底动脉扩张引起的舌咽神经痛是一种罕见的神经性疼痛，存在诊断和治疗挑战。
方法：一名67岁的男子在左侧口腔出现严重灼痛，在牙科和耳鼻喉科评估期间没有解释性发现。TMJ检查显示压痛，全景X线照片显示非贡献性根尖周射线不透性。MRI/MRA显示异常弯曲的椎动脉压迫舌咽神经和脑干。局部用利多卡因减轻疼痛，确认舌咽神经痛（GPN）。卡马西平最初无效,但是在视觉模拟量表上，200毫克的疼痛从90减少到20。患者要求并接受了微血管减压术（MVD）手术，消除了他的痛苦。
结论：当椎动脉压迫舌咽神经时，疼痛更加强烈，归因于其较厚的血管结构。局部麻醉测试有助于识别GPN。牙医必须熟练诊断，并具备准确评估和转诊咽喉和耳痛的解剖学知识。
方法：一名67岁的男子在左侧口腔出现严重灼痛，在牙科和耳鼻喉科评估期间没有解释性发现。TMJ检查显示压痛，全景X线照片显示非贡献性根尖周射线不透性。MRI/MRA显示异常弯曲的椎动脉压迫舌咽神经和脑干。局部用利多卡因减轻疼痛，确认舌咽神经痛（GPN）。卡马西平最初无效,但是在视觉模拟量表上，200毫克的疼痛从90减少到20。患者要求并接受了微血管减压术（MVD）手术，消除了他的痛苦。
结论：当椎动脉压迫舌咽神经时，疼痛更加强烈，归因于其较厚的血管结构。局部麻醉测试有助于识别GPN。牙医必须熟练诊断，并具备准确评估和转诊咽喉和耳痛的解剖学知识。
