General information

Glycerol is a colorless syrupy liquid that is used medically as a laxative given orally, as an enema, or in the form of suppositories. Oral hypertonic glycerol has been used as a test for reversibility of the symptoms of Ménière’s disease [ ]; however, it causes headache, nausea, and vomiting and is of poor sensitivity and specificity.

Intravenous glycerol has been given to reduce cerebral edema and hence reduce intracranial pressure.

Iodinated glycerol is used as a mucolytic agent in respiratory disorders. Organically bound iodine is changed to unbound iodide after absorption. Iodide inhibits the binding of iodine to the tyrosine residue of the thyroglobulin molecule, inhibiting the synthesis of thyroxine and triiodothyronine. In patients with iodide-induced goiter, there is increased iodine transport, further reducing thyroid hormone synthesis and causing thyroid hyperplasia [ ].

Glycerol has been injected into nerve ganglia to destroy them. In 139 patients, 260 consecutive retrogasserian glycerol rhizotomies for trigeminal neuralgia were retrospectively analysed for technical surgical difficulties and immediate and early complications [ ]. There were technical obstacles in 47%. In 21 cases, the surgical procedure had to be interrupted because of vasovagal reactions, cardiac arrest, or difficulty in finding the trigeminal cistern. There were either transient or persistent complications in 67%, in most cases mild sensory defects. Other complications included labial herpes (3.8%), anesthesia dolorosa (0.8%), moderately or severely impaired sensation (19%), dysesthesia (23%), chemical meningitis (1.5%), and infectious meningitis (1.5%). In five patients hearing was affected, including deterioration of pre-existing tinnitus in one case. Although the frequency of surgical difficulties was high, success was hampered only in a few procedures.

Organs and systems

Nervous system

In 122 patients with trigeminal neuralgia who underwent percutaneous retrogasserian glycerol injection [ ], complications associated with the treatment were significant: 63% had marked hyperesthesia of the face and 29% unpleasant dysesthesias, including two cases of anesthesia dolorosa. Sensory disturbances were most frequent in patients who had previously undergone an alcohol block procedure. Because of the high rates of recurrence and sensory disturbances, the authors preferred microvascular decompression for the management of trigeminal neuralgia. In a study of glycerol injection in trigeminal neuralgia, paresthesia and dysesthesia were reported [ ].

Rotatory vertigo with vertical nystagmus has been attributed to glycerol [ ].

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