by Dr. Michael Horowitz

Geniculate neuralgia causes severe, one sided pain located deep in the ear canal. The patient typically describes feeling as if a knife or icepick is being thrust into the deep ear causing sudden, intermittent, severe pain. What causes geniculate neuralgia? The cause is unknown.

How do you treat Geniculate neuralgia? There are generally no medications that successfully treat Geniculate neuralgia although we will at times try a few options. If these medications fail or is determined that they are not indicated then Geniculate neuralgia is treated by cutting the facial nerve that sits between the facial and auditory nerves and moving the blood vessels off the trigeminal nerve, the glossopharyngeal nerve, and the vagus nerve and placing small Teflon pillows between the nerves and blood vessels so that the blood vessels do not strike the nerves with each heartbeat.

In addition to cutting the NI, decompression of the trigeminal nerve, glossopharyngeal nerve, and vagus nerve is performed because these nerves also provide sensation to the eardrum and the walls of the ear canal. This procedure is called a microvascular decompression (MVD).

Patients undergoing the cutting of the nerve between the facial and auditory nerves and the MVD treatment have a greater than 90% chance of cure.

Your surgeon will discuss Geniculate neuralgia treatment options with you and recommend the best treatment for your case.