<p>The Long-Term Outcome of CT-Guided Pulsed Radiofrequency in the Treatment of Idiopathic Glossopharyngeal Neuralgia: A Retrospective Multi-Center Case Series</p>

Abstract

Background: Safer and minimal invasive treatment options with minor side effects are in great demand in the treatment of glossopharyngeal neuralgia (GPN). Pulsed radiofrequency (PRF) is a micro-destructive procedure that could be applied repeatedly without irreversible damage to target tissue. However, few studies have reported the long-term clinical outcomes of PRF in the management of idiopathic GPN patients. Methods: We retrospectively investigated the efficacy and safety of computed tomography (CT)-guided PRF in the treatment of 30 patients with idiopathic GPN in a multi-center clinical study. Numeric rating scale (NRS) score was used to evaluate pain intensity before and after PRF treatment. The effective rate was defined as the percentage of patients with NRS reduction of more than 50%. Baseline characteristics, surgical records, initial pain relief, time to take effect, long-term outcomes, patient satisfaction using a five-level Likert Scale, the incidence of recurrence as well as subsequent treatment choices, intraoperative and postoperative complications were retrieved from electronic medical records. Results: A total of 30 idiopathic GPN patients who received PRF under CT-guidance were included in our study and the initial effective rate was 93.3%. The cumulative proportion of patients with satisfactory pain relief survival was 93.3% at 12 months, 89.6% at 24 months, 85.3% at 36 months, 79.6% at 48 months, 73.0% at 60 months and 72 months, and 54.8% at 84 months, 108 months as well as 120 months. No serious morbidity or mortality were observed in any of the cases. The median patient satisfaction in Likert scale rating was 4.0 (IQR, 3.0-5.0). Conclusion: According to our results, PRF is an effective and safe therapy for patients with idiopathic GPN. This minimally invasive, micro-destructive, neuro-modulatory technique could be a potential intervention of choice for the treatment of GPN patients who respond poorly to pharmacological treatment.

Long-Term Follow-Up of Ultrasound-Guided Glossopharyngeal Nerve Block Treatment for Glossopharyngeal Neuralgia: A Retrospective Clinical Study of 43 Cases

“… 16 , 24 Another study conducted by Jia et al demonstrated that PRF could provide early pain relief with an efficacy rate of 93.3%. 25 Overall, these studies concluded that minimally invasive treatments such as RFT, and PRF are effective in reducing GPN-related pain. However, these treatments can have adverse effects, such as hoarseness and difficulties with drinking and swallowing.…”

“…However, no similar findings were observed in the other two retrospective studies on PRF and RFT treatment of GPN. 16 , 25 Hence, this speculation requires confirmation through larger prospective research samples.…”

Glossopharyngeal Neuralgia: Epidemiology, Risk factors, Pathophysiology, Differential diagnosis, and Treatment Options

“…They concluded that over the long term, pulsed radiofrequency is an efficient and safe treatment option for those afflicted with GPN. 35 Because of the success of pulsed radiofrequency in reducing the painful symptoms of GPN, some researchers wanted to see if performing the same minimally invasive procedure would have a similar outcome in patients with oropharyngeal carcinoma who were experiencing neuralgia due to the same glossopharyngeal nerve. The study looked at 25 patients with oropharyngeal carcinoma and for more than 3 months, the PRF provided a significant reduction in pain and improvement in sleep in 23 of the patients (92%).…”

Percutaneous radiofrequency thermocoagulation and microvascular decompression for treating glossopharyngeal neuralgia: a retrospective clinical study

“…A nerve block is performed via the lateral cervical approach [ 7 ]. Meanwhile, surgical treatment approaches for GPN include pulsed radiofrequency [ 8 ], percutaneous radiofrequency thermocoagulation(PRT) [ 9 ], microvascular decompression(MVD) [ 10 ], and stereotactic body radiation therapy [ 11 ]. These treatments aim to relieve pain and improve patients’ sleep and quality of life.…”