Glossopharyngeal neuralgia presents as severe pain in the oropharyngeal and otic regions, classically triggered by swallowing, and is typically caused by neurovascular compression, although a minority of cases may be caused by trauma, an elongated calcified stylohyoid ligament, and neoplasms along the course of the nerve, including in the neck [142,143]. CT Head There is no relevant literature to support the use of routine noncontrast head CT in the initial evaluation of oropharyngeal neurogenic dysphagia or oropharyngeal pain. CT Maxillofacial There is no relevant literature to support the use of maxillofacial CT in the initial evaluation of oropharyngeal neurogenic dysphagia or oropharyngeal pain. CT Temporal Bone There is no relevant literature to support the use of temporal bone CT in the initial evaluation of oropharyngeal neurogenic dysphagia or oropharyngeal pain. CT Neck Neck CT is complementary to MRI orbits, face, and neck in assessing patients with isolated CN IX palsy. Neck CT can delineate skull base erosion, identify deep space neck masses, intratumoral calcification, and the bony margins of the jugular foramen and nearby skull base foramina as well as image the extracranial course of the CN IX and its innervated structures in the pharynx and carotid space [144-148]. It does not image the intracranial course of CN IX or the brainstem well, which are best assessed with MRI. Imaging protocols should include thin-cut high- resolution bone windows through the posterior skull base. Contrast is strongly preferred for soft tissue characterization. There is no relevant literature to support the use of combined pre- and postcontrast imaging. CT neck is also useful to characterize the anatomy of the stylohyoid ligament in patients with glossopharyngeal pain [142]. In cases of glossopharyngeal neuralgia, imaging should include the pharynx and larynx to exclude a mucosal neoplasm as an etiology.
Cranial Neuropathy. Glossopharyngeal neuralgia presents as severe pain in the oropharyngeal and otic regions, classically triggered by swallowing, and is typically caused by neurovascular compression, although a minority of cases may be caused by trauma, an elongated calcified stylohyoid ligament, and neoplasms along the course of the nerve, including in the neck [142,143]. CT Head There is no relevant literature to support the use of routine noncontrast head CT in the initial evaluation of oropharyngeal neurogenic dysphagia or oropharyngeal pain. CT Maxillofacial There is no relevant literature to support the use of maxillofacial CT in the initial evaluation of oropharyngeal neurogenic dysphagia or oropharyngeal pain. CT Temporal Bone There is no relevant literature to support the use of temporal bone CT in the initial evaluation of oropharyngeal neurogenic dysphagia or oropharyngeal pain. CT Neck Neck CT is complementary to MRI orbits, face, and neck in assessing patients with isolated CN IX palsy. Neck CT can delineate skull base erosion, identify deep space neck masses, intratumoral calcification, and the bony margins of the jugular foramen and nearby skull base foramina as well as image the extracranial course of the CN IX and its innervated structures in the pharynx and carotid space [144-148]. It does not image the intracranial course of CN IX or the brainstem well, which are best assessed with MRI. Imaging protocols should include thin-cut high- resolution bone windows through the posterior skull base. Contrast is strongly preferred for soft tissue characterization. There is no relevant literature to support the use of combined pre- and postcontrast imaging. CT neck is also useful to characterize the anatomy of the stylohyoid ligament in patients with glossopharyngeal pain [142]. In cases of glossopharyngeal neuralgia, imaging should include the pharynx and larynx to exclude a mucosal neoplasm as an etiology.