1. Ultrasound-Guided Selective Pulsed Radiofrequency Treatment of Great Auricular Nerve for Post-Herpetic Neuralgia of the Head and Neck: A Case Report
- Author
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Song Wen, Yu Pi, Ting-Hua Wang, Ting-Ting Li, Hong-Su Zhou, and Liu-Lin Xiong
- Subjects
Auricle ,medicine.medical_specialty ,Gabapentin ,business.industry ,Pulsed radiofrequency ,Ultrasound ,pulsed radiofrequency ,Case Report ,medicine.disease ,Intensity (physics) ,Surgery ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,great auricular nerve ,Pulsed Radiofrequency Treatment ,medicine ,Neuralgia ,Great auricular nerve ,post-herpetic neuralgia ,business ,medicine.drug - Abstract
Objective The current study aimed to further verify the feasibility of ultrasound-guided selective pulsed radiofrequency (PRF) therapy of greater auricular nerve (GAN) in the treatment of head and neck post-herpetic neuralgia (PHN) by observing the efficacy and safety. Methods Under the guidance of high-frequency ultrasound (Frequency: 10 MHz), the GAN was identified by a radiofrequency electrode trocar with a transverse in-plane approach, which was inserted into the GAN, then the inner needle of the trocar was retracted. After adjusting the technical variables (electrode tip temperature: 42°C, output voltage: 60 V, pulse frequency: 2 Hz, pulse width: 22 ms, single duration: 240 s, two times), the radiofrequency electrode placed on the auricle and below the ear for sensory and motor tests began to work. Results The pain in the left head and neck of the patient lasted for more than 1 month, we decided to try selective PRF of GAN guided by ultrasound for the first time. Immediately after the treatment, 11-point pain intensity numerical rating scale (PI-NRS) score ranged from 5 to 1. During his hospitalization, mecobalamine and gabapentin were taken instead of opioids. Seven days after the procedure, PI-NRS score was 2, the degree of numbness the patient he felt by himself in the original lesion area relieved from 100% to 40%, the depression module of the Patient Health Questionnaire-9 (PHQ-9) score was from 7 to 5, the Generalized Anxiety Disorder-7 (GAD-7) score from 8 to 4, the range of pain areas was reduced to external auditory tract, and there were no adverse events occurring. Conclusion The ultrasound-guided selective PRF treatment of GAN was safe and effective in the improvement of PHN in the head and neck, which is worthy of clinical promotion.
- Published
- 2021