Efficacy of radiofrequency thermocoagulation guided by three-dimensional computer tomography for treatment of severe recurrent glossopharyngeal neuralgia

Abstract

Objective To evaluate the efficacy of radiofrequency thermocoagulation guided by three-dimensional computer tomography(3-D CT)for the treatment of severe recurrent glossopharyngeal neuralgia(GPN). Methods Twenty-nine patients of both sexes with recurrent intractable GPN, aged 42-75 yr, with recurrent course of 1-8 yr, of Barrow Neurological Institute(BNI)Pain Scale(BNI-P)class Ⅳ or Ⅴ, were enrolled in this study.Percutaneous radiofrequency thermocoagulation was applied to the middle and lower segment of the styloid process of the glossopharyngeal nerve under 3D CT guidance.Before operation and at 72 h, 6 months and 1 year after operation, BNI-P class and BNI Numbness Scale scores were recorded, and effective treatment and operation-related complications were also recorded. Results Nineteen patients underwent one operation, 8 patients underwent two operations, and 2 patients underwent three operations.BNI-P class was significantly lower at each time point after operation than before operation(P<0.05). The rate of effective treatment was 100% at 72 h and 6 months after operation and 97% at 1 yr after operation.Different degrees of dysesthesias at the posterior part of the tongue on the affected side occurred after operation and disappeared at 1 yr after operation.Operation-related nausea and vomiting, facial nerve damage, accessory nerve damage and fatality were not observed. Conclusion 3D CT-guided radiofrequency thermocoagulation of the glossopharyngeal nerve provides reliable efficacy and higher safety for the patients with severe recurrent GPN. Key words: Tomography; Imaging, three-dimensional; Electrocoagulation; Glossopharyngeal nerve diseases