Effectiveness and Safety of Radiofrequency Thermocoagulation Treatment Guided by Computed Tomography for Infraorbital Neuralgia Following Failed Conservative Treatment: A Retrospective Study

Abstract

Purpose

To evaluate the effectiveness and safety of CT-guided radiofrequency thermocoagulation (RFT) for the treatment of infraorbital neuralgia following the failure of conservative management.

Patients and Methods

This was a single center, retrospective study which included 196 patients between the ages of 37 to 90 years, who suffered from infraorbital neuralgia, and had undergone CT-guided RFT treatment. The medical records of these patients were retrieved between January 7, 2015 and February 5, 2020, and the patients were followed up for 2 years. Follow-up outcomes included Numerical Rating Scale (NRS) scores, dosage of carbamazepine, time to take effect, status of recurrence and side effects. The effective rate was defined as the percentage of patients with postoperative NRS score reduction of >50%.

Results

The effective rates were 92.9%, 100%, 100%, 100%, 93.4% and 85.7% on the same day, week 1, month 1, month 6, year 1 and year 2 after RFT, respectively. After RFT, the postoperative NRS scores and dosage of carbamazepine were significantly reduced than those preoperatively (P < 0.05). The median time to take effect was zero day. Twenty-eight patients with recurrence underwent RFT again and achieved complete pain relief. All patients experienced numbness in the infraorbital nerve innervation area and the numbness scores gradually decreased over time.

Conclusion

CT-guided RFT treatment may be an effective and safe technique for pain relief in patients with infraorbital neuralgia following failed results from conservative treatment.

Keywords:

• infraorbital neuralgia
• radiofrequency thermocoagulation
• effectiveness
• safety
• retrospective study

Abbreviations

NRS, numeric rating scales; PRF, pulsed radiofrequency; CRF, continuous radiofrequency; RFT, radiofrequency thermocoagulation; CT, computed tomography; ECG, electrocardiogram; HR, heart rate; BP, blood pressure; RR, respiratory rate; BMI, body mass index; SDs, standard deviations; IQRs, interquartile ranges; NSAIDs, nonsteroidal anti-inflammatory drugs.

Data Sharing Statement

Patient data will not be available because this was not a concern when the study was conducted and the patients were not informed.

Ethics Approval and Informed Consent

Ethics approval was obtained from the Ethics Committee of Beijing Tiantan Hospital, Capital Medical University. The application for a waiver of informed consent for this study was approved.

Consent for Publication

All the authors confirm that the details of any images, videos, recordings, etc. can be published, and the consent has been shown for the article contents to be published. Authors are prepared to provide copies of signed consent forms to the journal editorial office, if requested.

Acknowledgment

We thank the patients who enrolled in this study.

Disclosure

The authors declare that they have no conflicts of interest in this work.

Additional information

Funding

This research was supported by the Capital’s Funds for Health Improvement and Research (No. 2020-2-2046), the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. XMLX201707) and the Foundation for the Excellent Medical Staff of Beijing (No. 2014-3-035). The funders had no role in the study design, data collection, data analysis, data interpretation, or writing of the manuscript. The corresponding author had complete access to all the data in the study; all the co-authors were responsible for making the final decision to submit for publication.