Recently, the neurosurgery department of our hospital successfully completed a case of microvascular decompression for linguopharyngeal neuralgia using minimally invasive surgery, which is the first patient with linguopharyngeal neuralgia treated since the neurosurgery department carried out microvascular decompression surgery, and achieved very good treatment results. The patient, a local resident of Shanghai in her 60s, had been suffering from pain in the right lower jaw and pharynx for more than half a year. Since the onset of the disease, eating, drinking and even opening her mouth to speak caused severe pain, which seriously affected the patient’s daily life. She went to a number of major hospitals in the city for consultation, underwent many tests: CT, MRI, electromyography, etc., and took a variety of medications, but to no avail. Because of the pain and the impact on eating, the patient was losing weight and became irritable. The patient was introduced to Shanghai Tongji Hospital and consulted with Dr. Fei Wang, the deputy chief of neurosurgery, who arranged for the patient’s admission with enthusiasm and quickly arranged to complete the preoperative examination. Dr. Wang arranged for the patient to be admitted to the hospital with enthusiasm and quickly completed the preoperative examination. Director Hai-ship and Deputy Director Wang Fei formulated a detailed surgical plan and talked to the family repeatedly and seriously to dispel the patient’s and family’s concerns and hesitations. On the third day after admission, surgery was scheduled. An incision of about 8 cm long was made behind the right ear, and a small bone window of 3×3 cm was drilled in the skull. Director Hai-Shang and Deputy Director Wang Fei cooperated well under the microscope, carefully and meticulously combed the whole course of the linguopharyngeal nerve fully and completely released the compression of the blood vessel. 3 hours later, the operation was successfully completed. After the patient woke up one hour after the operation, Dr. Wang asked the patient with concern. The patient told the doctor in a weak but pleasant voice that the pain in the right side of the jaw and pharynx was completely relieved. At present, the patient is still in hospital and will be discharged when the stitches are removed. Therefore, doctors warn that patients with recurrent episodes of severe pain located in the tonsils and linguopharynx that are difficult to relieve and for whom medication is ineffective may consider minimally invasive surgery to treat linguopharyngeal neuralgia. Related links: Primary glossopharyngeal neuralgia is an episodic severe pain confined to the distribution of the glossopharyngeal nerve. The etiology and pathogenesis of this condition have not yet been fully understood. In recent years, the development of microsurgery has revealed that the patient’s linguopharyngeal nerve is compressed by the vertebral artery or the posterior inferior cerebellar artery. The common age of predilection: 35-50 years old, more common in men than in women. The sudden onset of pain, the nature of which is like a knife cut, over the electricity, located in the tonsils, tongue root, pharynx, deep ear canal, etc., is intermittent episodes, each lasting a few seconds to 1 to 2 minutes, can be triggered by swallowing, speech, coughing, yawning, etc., with foreign body sensation and infarction, the onset of foreign body sensation and infarction in the pharynx and larynx. At present, the main treatment methods are: 1. Drug treatment: oral phenytoin sodium, vitamin B1, B12, carbamazepine, etc. However, as the pain increases, the drugs often lose their effect after several months or years. 2. Nerve block: the method is percutaneous perforation of the jugular vein hole radiofrequency treatment, which is suitable for: ① drug treatment is ineffective or can not tolerate drug adverse reactions; ② senior age or poor general condition, can not tolerate microvascular decompression surgery. The main problems of this treatment method are high recurrence rate of pain and nerve damage resulting in dysphagia, choking and hoarseness, etc. 3. Microvascular decompression surgery: Microvascular decompression surgery is the safest and most effective surgical treatment method at present, and its cure rate can reach more than 90%, and most patients’ pain can disappear after surgery. Microvascular decompression was first proposed by Professor Jannatta in 1967. Microvascular decompression is the only method to treat the cause of glossopharyngeal neuralgia, and it can preserve the anatomical integrity of the glossopharyngeal nerve, so the normal nerve function of the glossopharyngeal nerve can be preserved. Because microvascular decompression has the advantages of significant pain relief, non-destructive, minimal side effects, and very low recurrence rate, it is currently the safest and most effective method internationally recognized for the treatment of glossopharyngeal neuralgia.