How I do it: endoscopic microvascular decompression for glossopharyngeal neuralgia

Background: Microvascular decompression (MVD) for glossopharyngeal neuralgia (GPN) is associated with high complication and incomplete cure rates because of its poor ability to visualize neurovascular conflicts. Method: Fully endoscopic MVD for GPN was carried out through a retrosigmoid keyhole approach. Neurovascular conflicts were clearly demonstrated with a loop of the posterior inferior cerebellar artery (PICA) under a 30° endoscopic view, and no significant cerebellar retraction was observed. The loop of the PICA was safely decompressed and the perforators were preserved while offering an excellent operative view. Conclusion: Endoscopic MVD is a reliable and minimally invasive method for GPN.