Medications used for trigeminal neuralgia can sometimes control GPN pain. Surgical interventions are considered when the pain becomes severe and medical therapy does not provide adequate pain relief or causes unacceptable side effects.

     A rhizotomy procedure involves sectioning of the glossopharyngeal nerve and upper rootlets of the vagus nerve. This effectively relieves the pain for the majority of sufferers, but may however, cause swallowing problems due to the nerve injury. The rhizotomy is usually performed with open surgery similar to Microvascular decompression surgery.

      Microvascular decompression surgery for GPN relieve the compression of blood vessels upon the IXth and Xth cranial nerve rootlets emerging from the lateral medulla. This surgery does not injure the nerves, and cures GPN in about three-quatres of patients. Compared to rhizotomy procedures, the recurrence of GPN is less likely following MVD.

    Percutaneous radiofrequency rhizotomy for GPN is performed with a needle advanced through the cheek to the skull base, directed to produce injury of the IX and X cranial nerves. This procedure involves a higher risk of producing numbness and swallowing difficulties. However, it is well-suited for treatment of secondary GPN, when the tumor has already damaged the nerve function. In such cases, treatment of the tumor itself may reduce the GPN pain. Percutaneous radiofrequency rhizotomy is also an option for sufferers who are not candidates for other more invasive surgical procedures.

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