Pulsed Mode Radiofrequency Lesioning to Treat Chronic Post‐tonsillectomy Pain (Secondary Glossopharyngeal Neuralgia)

Shah, Rinoo V.; Racz, Gabor B.

doi:10.1046/j.1533-2500.2003.03028.x

Cited by 29 publications

(23 citation statements)

References 31 publications

(85 reference statements)

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“…Few case reports have shown the efficacy of PRF ablation in GPN. Shah et al (6) presented the first case report of post tonsillectomy chronic GPN successfully treated with PRF ablation. Another case reports published by Abejon (7) and Chua et al (8) also revealed the efficacy of PRF ablation of glossopharyngeal nerve in non-cancer patients.…”

Section: Prf Of Glossopharyngeal Nervementioning

confidence: 99%

Pulsed Radiofrequency Ablation for the Treatment of Glossopharyngeal Neuralgia Secondary to Oropharyngeal Carcinoma

Dnb

2018

Pain Phys

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Background: The management of glossopharyngeal neuralgia due to oropharyngeal carcinoma is particularly difficult because of rich innervations of the area, erosive nature of neoplasm and dynamic pain evoked by the functional movements like swallowing and chewing. Few case reports have shown the efficacy of pulsed radiofrequency (PRF) treatment in primary and secondary glossopharyngeal neuralgia in non-cancer patients. However, the efficacy of PRF ablation of the glossopharyngeal nerve in oral cancer patients is not known. Objectives: This study was conducted to evaluate the efficacy and safety of PRF ablation of the glossopharyngeal nerve for the management of oropharyngeal cancer pain involving the base of the tongue, tonsillar fossa, and oropharynx. Study Design: Prospective interventional clinical trial. Setting: Tertiary care hospital and medical education and research institute. Methods: A total of 25 adult patients suffering from oropharyngeal carcinoma, complaining of severe pain in the area mainly supplied by glossopharyngeal nerve, were included. The patients underwent fluoroscopy-guided PRF ablation of the glossopharyngeal nerve of the affected site 3 times at 42°C temperature for 120 seconds with 22-gauge, 10 cm long, 5 mm active tip radiofrequency needle. They were followed up for one year for pain relief, nausea-vomiting and sleep disturbances. The treatment was considered effective if there was 50% reduction in pain score at 2 weeks. Results: There was significant reduction in the overall pain score including site specific pain, odynophagia and ear pain after radiofrequency ablation (P < 0.0001) in all the patients. This was associated with decreased opioid consumption (P < 0.001), lesser nausea/vomiting, and improved sleep. The treatment was effective in 23 out of 25 patients (92%) for more than 3 months. No major complication was observed in any patient. The average duration of effective pain relief was 5 to 9 months. Limitations: Patients having bilateral glossopharyngeal neuralgia or an advanced stage of oral cancer with large lymph nodes at the angle of mandible were not included. This study was a singlecenter observational clinical trial and further multi-center, randomized, controlled trails are needed to obtain higher level of evidence. Conclusion: Our results showed that PRF ablation can be used effectively and safely for the treatment of glossopharyngeal neuralgia secondary to oropharyngeal carcinoma. Key words: Glossopharyngeal neuralgia, ear pain, odynophagia, oral cancer pain, pulsed radiofrequency ablation, side effects

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Section: Prf Of Glossopharyngeal Nervementioning

confidence: 99%

Pulsed Radiofrequency Ablation for the Treatment of Glossopharyngeal Neuralgia Secondary to Oropharyngeal Carcinoma

Dnb

2018

Pain Phys

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“…Currently, RF and PRF are used for the treatment of facet joint disease (11), radicular pain (11,12), sacroiliac joint disease (11), and trigeminal (11,13) and other neuralgias (14–18). Overall, there is a decreased incidence of side effects and complications from PRF when compared to RF treatment (11,12).…”

Section: Introductionmentioning

confidence: 99%

Application of Pulsed Radiofrequency Currents to Rat Dorsal Root Ganglia Modulates Nerve Injury–Induced Tactile Allodynia

Perret¹,

Kim

Li³

et al. 2011

Anesthesia &Amp; Analgesia

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Background Application of pulsed radiofrequency (PRF) currents to the dorsal root ganglia (DRG) has been reported to produce relief from certain pain states without causing thermal ablation. In this study, we examined the direct correlation between PRF application to DRG associated with spinal nerve injury and reversal of injury-induced behavioral hypersensitivity in a rat neuropathic pain model. Methods Neuropathic lesioning was performed via left L5 spinal nerve ligation on male adult Sprague-Dawley rats. Once the injured rats had developed tactile allodynia, one group was then assigned to PRF treatment of the L5 DRG and another group was assigned to the sham treatment to the DRG. Behavioral testing was performed on both the control and treated paws using the von Frey filament test before the surgery and at indicated days. The resulting data were analyzed using a linear mixed model to assess the overall difference between the treatment groups and the overall difference among the study days. Cohen’s d statistic was computed from paired difference-from-baseline scores for each of the 14 study days after treatment and these measures of effect-size were then used to descriptively compare the recovery patterns over time for each study group. Results Spinal nerve injury resulted in the development of behavioral hypersensitivity to von Frey filament stimulation (allodynia) in the hindpaw of the left (injury) side. Mixed Linear modeling showed a significant difference between the treatment groups (p = 0.0079) and a significant change of paw withdrawal threshold means over time (p = 0.0006) for all 12 animals. Evaluation of Cohen’s d (effect size) revealed that the PRF-treated animals exhibited better recovery and recorded larger effect-sizes than the sham-treated animals on 10 of the 14 post-PRF treatment days and exhibited moderate to strong effects posttreatment at days 8–10 and at and beyond day 32. Conclusions Findings from this study support that PRF of the DRG causes reversal of nerve injury (spinal nerve ligation)-induced tactile allodynia in rats. This allodynia reversal indicates that nonablative PRF acting via modulation of the DRG can speed recovery in nerve injury-induced pain.

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“…Finally, we found 18 case reports and case series including a total of 105 patients: two cases with glossopharyngeal neuralgia [48] and one case of chronic post‐tonsillectomy pain [49], one post‐traumatic headache [50], three patients with groin pain and orchialgia [51], four patients with chronic back pain syndromes [24], seven patients with occipital neuralgia [52], eight patients with SIJ pain [53], and 39 patients with discogenic pain responsive to L2 DRG block [54]. Other abstracts reported on cases with meralgia paresthesia [55], neuropathic pain [56], postherpetic neuralgia of head and face [57], complicated whiplash [58], and suprascapular nerve for shoulder pain [59].…”

Section: Resultsmentioning

confidence: 99%

Pulsed Radiofrequency: Current Clinical and Biological Literature Available

Zundert²,

et al. 2006

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The accumulation of these data shows that the use of pulsed radiofrequency generates an increasing interest of pain physicians for the management of a variety of pain syndromes. Although the mechanism of action has not been completely elucidated, laboratory reports suggest a genuine neurobiological phenomenon altering the pain signaling, which some have described as neuromodulatory. No side effects related to the pulsed radiofrequency technique were reported to date. Further research in the clinical and biological effects is justified.

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Pulsed Mode Radiofrequency Lesioning to Treat Chronic Post‐tonsillectomy Pain (Secondary Glossopharyngeal Neuralgia)

Cited by 29 publications

References 31 publications

Pulsed Radiofrequency Ablation for the Treatment of Glossopharyngeal Neuralgia Secondary to Oropharyngeal Carcinoma

Pulsed Radiofrequency Ablation for the Treatment of Glossopharyngeal Neuralgia Secondary to Oropharyngeal Carcinoma

Application of Pulsed Radiofrequency Currents to Rat Dorsal Root Ganglia Modulates Nerve Injury–Induced Tactile Allodynia

Pulsed Radiofrequency: Current Clinical and Biological Literature Available

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