CT-guided percutaneous radiofrequency thermocoagulation for glossopharyngeal neuralgia: A retrospective clinical study of 117 cases

Abstract

ObjectiveGlossopharyngeal neuralgia (GPN) is a rare disorder of the ninth cranial nerve. Percutaneous radiofrequency thermocoagulation (PRT) is an established treatment for neuropathic pain. Since PRT was first applied with GPN, only a few studies have provided detailed reports on its clinical outcomes and complications, and the number of cases was small. The aim of this study was to investigate the effects, incidence rates, and severity of adverse events of computed tomography (CT)-guided PRT in 117 patients with GPN. Patients and methodsA total of 117 patients with idiopathic GPN underwent CT-guided PRT from July 2004 to December 2016. A retrospective review of medical records was performed to investigate baseline characteristics and immediate outcomes after operation. Long-term outcomes were obtained via telephone interviews. Patients were followed up at 3 months, 6 months, and thereafter, every year after operation. According to Barrow Neurological Institute (BNI) pain scale, the effects of this treatment were categorized into 5 levels. Adverse events, frequencies, severity, and recovery times of complications were recorded. ResultsPatients who were classified into BNI class I and BNI class II experienced excellent pain relief. Ninety-six patients (82.1%) achieved “excellent” pain relief immediately after treatment. The mean follow-up period was 73.6 months (range, 13–150). With regard to long-term outcomes, the percentage of patients who experienced “excellent” pain relief was 75.9% at 1 year, 63.0% at 3 years, 54.0% at 5 years, 44.2% at 10 years, and 39.3% at 12.5 years. Complications, which included dysphagia, lingual numbness, pharynx and larynx numbness, hoarseness, and abnormal sense of taste, were graded 1 as defined by the Landriel Ibanez classification, and all complications disappeared within 12.9 ± 5.1 weeks. ConclusionThis study indicates that PRT is a minimally invasive procedure that leads to minor complications and is proven to have immediate and long-term effectiveness for managing GPN. It is especially suitable for patients with contraindication to surgery and patients who require recurrent treatment. We provide a detailed report of the adverse events experienced by GPN patients who underwent PRT.