Geniculate neuralgia is a condition where a small nerve (the nervus intermedius) is compressed by a blood vessel. This results in severe, deep ear pain which is usually sharp—often described as an "ice pick in the ear"—but may also be dull and burning, and can be accompanied by facial pain. This pain can be triggered by stimulation of the ear canal, or can follow swallowing or talking.
Doctors will typically prescribe treatment with medication before recommending surgery. If surgery is required, UPMC’s neurosurgeons may recommend Microvascular Decompression. Microvascular decompression is a surgical procedure that relieves abnormal compression of a cranial nerve.
Your physician will perform a physical exam and will ask about your symptoms.
Symptoms may include:
- An intermittent stabbing pain, like an electric shock, deep in the ear.
- Some patients have reported salivation, bitter taste, tinnitus, and vertigo during these pain attacks
Several medications are available to treat geniculate neuralgia, including Tegretol or Sansert. Surgery is reserved for those patients who are not helped by drug treatments or who experience undesirable side effects from them. UPMC’s neurosurgeons typically recommend Microvascular Decompression and cutting the affected nerve. This procedure has minimal side effects.