Skull Base Institute

Sahag B., Glendale, CA

I am a sixty-eight year old ophthalmologist. Some years ago, I started having severe, recurrent pain in my left jaw that was increasing in frequency, severity and duration. It was completely affecting my life. I sought advice from my dentist, a pain specialist, neurologist and otorhinolaryngologist. Regular radiology, CT scan, and MRI did not reveal any lesions. Narcotics helped temporarily.

Finally, one of my ENT colleagues said, “I think I know what you have, although I have never seen a case before.” He performed a block of my glossopharyngeal nerve (9th cranial nerve) and the pain disappeared for about 3 hours. He said he knew just the specialist to help me. On Christmas Eve, he called Dr. Hrayr Shahinian, who met me at Cedars-Sinai. Dr. Shahinian told me that he concurred with my colleague’s diagnosis. He said that my condition was due to an abnormally situated arteriosclerotic left posterior inferior cerebellar artery pressing on the glossopharyngeal nerve. Dr. Shahinian ordered an MRI that confirmed his diagnosis.

Dr. Shahinian referred me back to my neurologist for medical treatment to suppress the pain. He said that only when the medical treatment failed would I be a candidate for endoscopic surgery to separate the nerve and artery and to cut the sensory branch of the glossopharyngeal nerve.

For two years, I was relatively pain-free on Neurontin and Tegretol. Those medications controlled the pain, but they also slowed me mentally and physically. Therefore, I decided to end my surgical practice and reduce the clinical practice to a level where I could give quality care to my patients. Over time, the Neurontin was increased to over 2400 mgs. a day in addition to 400 mgs of Tegretol XR. Even at these dosages, I was having break-through pain.

My family and I agreed it was time for surgical intervention. I had wanted the surgery from day one, but Dr. Shahinian insisted on medical treatment with surgery as a last option. Eventually, I underwent the intervention, and I have not had glossopharyngeal neuralgia since. Today, I have an active clinical practice that is limited only by my general health. I have referred two patients from my practice to Dr. Shahinian. One patient had trigeminal neuralgia and the other had a pituitary tumor. Both patients are happy with the outcomes of their surgery.

Dr. Shahinian was very forthcoming about any questions I had. He explained all the probable and possible complications of the surgery. I had some complications that subsided over the next month. The only residual problem is numbness at the back of my throat, which is expected when the sensory portion of the nerve is cut.

I lead a productive, happy, pain-free life thanks to the excellent care I received. Dr. Shahinian is a very pleasant, helpful and gentle person on top of being a superior surgeon and physician. Without his help, I would have not been able to live with that pain. Without his help, I would have committed suicide in spite of my Christian faith.

Sahag B.
Glendale, CA

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