Abstract
Glossopharyngeal neuralgia is an uncommon facial syndrome with significant deleterious effect on the quality of life. The glossopharyngeal nerve is predominantly a sensory nerve with a limited number of motor and autonomic fibers. The central causes of glossopharyngeal neuralgia are commonly treated with neurosurgical interventions. Medical therapy and nerve blocks are predominantly used to treat peripheral causes of glossopharyngeal neuralgia. In this review article, we present clinical vignettes and describe practical aspects of intra-oral, extra-oral, and peripheral techniques to block the glossopharyngeal nerve. The glossopharyngeal nerve blocks should be performed in a monitored setting due to the potential for adverse complications.
Highlights
Facial pain syndromes are commonly associated with a significant effect on a patient’s quality of life1
We present clinical vignettes and describe practical aspects of intra-oral, extra-oral, and peripheral techniques to block the glossopharyngeal nerve
The glossopharyngeal nerve blocks should be performed in a monitored setting due to the potential for adverse complications
Summary
Facial pain syndromes are commonly associated with a significant effect on a patient’s quality of life. After her tonsillectomy surgery, the patient had a prolonged empiric course of antibiotics under the guidance of an infectious disease specialist. GN was suspected, and a GNv block was suggested to confirm the diagnosis She was interested and extremely anxious about the invasive approach to the glossopharyngeal nerve, especially in the light that she had not had much success with any previous treatments. Intra-oral GNv Block: GN is a rare diagnosis that can occur uncommonly post-tonsillectomy, as in our patient. GNv block using cotton pledges soaked in local anesthetics has been used by anesthesiologists for the management of difficult airways to limit gag reflex. Fluoroscopic approach to extraoral GNv block: Panel A shows a lateral view with the highlighted styloid process between the jaw-bone and the mastoid process. Several randomized trials show the safety and efficacy of GNv block for patients undergoing tonsillectomy. 17,18
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