Zhu Qing, Wang Shulan, Chen Rui, Cai Xianbin, Jiang Cuihua, Zhong Baolin, Sun Tao
Department of Pain Management, The Affiliated Ganzhou Hospital of Nanchang University, Nanchang, Jiangxi, China Department of Pain Management, Orthopaedic Hospital of Gao'an City, Jiang Xi Province, Gao An, Jiangxi, China.
Medicine (Baltimore). 2018 Jun;97(24):e11079. doi: 10.1097/MD.0000000000011079.
Glosssopharyngeal neuralgia (GPN) is a painful syndrome characterized by paroxysmal neuropathic pain in the pharynx, tonsil, posterior base of tongue, inner ear, and mandibular angle. The traditional therapies of GPN, including medication and surgical operation, are not always effective in pain controlling. Radiofrequency therapy is a minimally interventional technique to provide analgesia in chronic pain.
Two patients who were refractory to medical treatment were hospitalized for primary GPN.
Two patients were diagnosed by symptoms, physical signs and imaging examination.
The first patient underwent pulsed radiofrequency of the glossopharyngeal nerve under CT-guidance as a preferred method. The pulsed radiofrequency (PRF) was performed at 42°C for 10 minutes with a pulsed frequency of 2 Hz and a pulse width 20 ms. There is no symptom improvement after PRF procedure. Three days later, continuous radiofrequency (CRF) thermocoagulation was performed. The pain disappeared after CRF within 36 months followed-up. CRF thermocoagulation under CT-guidance was accepted by the second patient as the first choice.
An overall reduction of pain was reported after the procedure and telephone consult for 24-months follow-up confirmed the persistence of the pain relief.
The CRF thermocoagulation produced no complications or side effects in the two cases, and was proved effective in the treatment of GPN.
舌咽神经痛（GPN）是一种疼痛综合征，其特征为咽部、扁桃体、舌根后部、内耳及下颌角处发作性神经性疼痛。GPN的传统治疗方法，包括药物治疗和外科手术，在控制疼痛方面并非总是有效。射频治疗是一种在慢性疼痛中提供镇痛的微创介入技术。
两名药物治疗无效的患者因原发性GPN住院。
两名患者通过症状、体征及影像学检查确诊。
首例患者首选在CT引导下行舌咽神经脉冲射频治疗。脉冲射频（PRF）在42°C下进行，持续10分钟，脉冲频率为2Hz，脉冲宽度为20ms。PRF治疗后症状无改善。三天后，进行了连续射频（CRF）热凝治疗。在36个月的随访中，CRF治疗后疼痛消失。第二例患者首选接受了CT引导下的CRF热凝治疗。
术后报告疼痛总体减轻，24个月随访的电话咨询证实疼痛持续缓解。
CRF热凝治疗在这两例患者中未产生并发症或副作用，且被证明对治疗GPN有效。
