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Treatment of Supraorbital Neuralgia Using Ultrasound-Guided Radiofrequency Thermocoagulation of the Supraorbital Nerve: A Retrospective Study

Authors Ren H, Shen Y, Luo F

Received 27 August 2019

Accepted for publication 18 January 2020

Published 29 January 2020 Volume 2020:13 Pages 251—259


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Michael A Überall

Hao Ren, Ying Shen,* Fang Luo*

Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Fang Luo; Ying Shen
Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, No. 119 West Road, South 4th Ring Road, Fengtai District, Beijing 100050, People’s Republic of China
Tel +86 13611326978; +86 18610791617

Purpose: There is no standard clinical treatment protocol for supraorbital neuralgia patients who respond poorly to conservative treatment. Radiofrequency thermocoagulation, a neurologically damaging procedure, is a treatment for supraorbital neuralgia. However, assessments of its long-term efficacy are lacking. Thus, this study aimed to evaluate the long-term efficacy and safety of ultrasound-guided radiofrequency thermocoagulation for treating supraorbital neuralgia.
Patients and Methods: We retrospectively reviewed our clinical database for supraorbital neuralgia patients who underwent an ultrasound-guided radiofrequency thermocoagulation procedure. Demographic data and baseline characteristics, time of onset, postoperative pain intensity, time of recurrence, subsequent treatment, complications and side effects were collected and analysed. The Kaplan-Meier estimator was used to determine recurrence-free survival.
Results: A total of 53 supraorbital neuralgia patients were included in this study. All patients experienced complete pain relief within one month. The median follow-up time of the 53 patients was 36.0 months (IQR, 12.0– 72.0 months). A total of 13 patients experienced pain recurrence, with a median recurrence-free time of 97 months according to the Kaplan-Meier estimator. The cumulative proportion of recurrence-free survival was 96.2% at 12 months, 88.4% at 24 months, 82.7% at 36 months, 70.0% at 48 months, 66.3% at 60 months, and 49.7% at 97 months. All but one patient with recurrent pain underwent a second or third radiofrequency thermocoagulation procedure and achieved complete pain relief. Numbness of supraorbital nerve innervation occurred in all patients. However, the numbness scores gradually decreased over time.
Conclusion: Ultrasound-guided radiofrequency thermocoagulation is a safe, effective treatment for supraorbital neuralgia patients who respond poorly to conservative treatments. These patients attained excellent long-term pain relief with a gradual reduction in numbness.

Keywords: supraorbital neuralgia, radiofrequency thermocoagulation, long-term efficacy, survival analysis

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