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Bipolar radiofrequency ablation for cancer pain in the trigeminal distribution
  1. Victor M Silva-Ortiz1,2 and
  2. Ricardo Plancarte-Sanchez2,3
  1. 1Pain Management Department, Hospital Zambrano Hellion, San Pedro Garza Garcia, Mexico
  2. 2Latin American Pain Society, New York City, New York, USA
  3. 3Pain Management, Mexico National Cancer Institute, Ciudad de Mexico, Mexico
  1. Correspondence to Dr Victor M Silva-Ortiz, Pain Management Department, Hospital Zambrano Hellion, 66278 San Pedro Garza Garcia, Mexico; drvictorsilva{at}gmail.com

Abstract

Tumours in patients with head and neck cancer (HNC) are associated with a more significant decrease in quality of life compared with the rest of patients with cancer. We present a patient with pain due to HNC successfully treated with bipolar radiofrequency ablation. A man in his 70s presented with a tumour in the left V2 and V3 region, with disabling pain, Visual Analogue Scale (VAS) score of 10/10, pain on swallowing, chewing and speaking, 3 months of evolution. The patient was evaluated in the pain management department, and the interventional treatment proposed consisted of bipolar pulsed radiofrequency, followed by bipolar thermal radiofrequency of the left V2 and V3 branches with fluoroscopic guidance to achieve better control and coverage of the affected trigeminal branches. Immediately after the procedure, the patient reported a significant improvement in pain with a 0–10 VAS; hypoesthesia in the affected V2 and V3 territory was identified, but no motor weakness. The improvement in pain was maintained for 6 months with a significant improvement in quality of life and pain, which allowed him to speak, chew and swallow without pain. Later, the patient died from complications associated with the disease. The treatment approach in these patients is both pain treatment and achieving independence by allowing better speech ability and improving eating, the above as a pillar of treatment focused on improving the patient’s quality of life. This approach is a potential tool in the early stage of the disease in patients with pain due to HNC.

  • Pain
  • Head and neck
  • Quality of life

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Footnotes

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  • Contributors Study conception and design—VMS-O. Analysis and interpretation of results—VMS-O and RP-S. Draft manuscript preparation—VMS-O and RP-S. Both authors reviewed the results and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.