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Geniculate Neuralgia

Last Updated: August 23, 2018

Nervus intermedius transection for geniculate neuralgia: Technique

Geniculate neuralgia, also called nervus intermedius neuralgia or primary otalgia, is a very rare type of facial neuralgia characterized by intermittent episodes of pain located deep in the ear and lasting for seconds or minutes. This neuralgic syndrome is often triggered by sensory or mechanical stimulation of the posterior wall of the external auditory canal. Fewer than 150 cases of this disorder have been reported in the English literature, so accurate data about prevalence, diagnosis, and treatment are not available.

The nervus intermedius takes its name from its intermediate position between the facial and superior vestibular nerves. It was first identified in 1563, and in 1777, Heinrich August Wrisberg named it the “portio media inter comunicantem faciei et nervum auditorium.” This nerve, often called the Wrisberg nerve, carries parasympathetic fibers to the lacrimal and nasopalatine glands and transmits sensory information from the tongue and various skin areas of the nose and concha of the ear. It travels alongside the motor component of the facial...