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Treatment of a patient with glossopharyngeal neuralgia by the anterior tonsillar pillar method.

Isbir CA - Case Rep Neurol (2011)

Bottom Line: Performing this GPN block, daily levobupivacaine (Chirocaine® 5 mg/ml) and oral amitriptyline (Laroxyl® 10 mg) were given, as well as methylprednisolone acetate injectable suspension (Depo-Medrol® 40 mg/ml) once only at the beginning of the treatment.Pain was successfully controlled with a steroid added to the GPN block and orally administered tricyclic antidepressant.We think that this treatment is effective for glossopharyngeal neuropathy and could be of interest to pain management physicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Harput State Hospital, Ministry of Health of Turkey, Elazig, Turkey.

ABSTRACT
We describe the case of a 65-year-old patient with glossopharyngeal neuralgia. Pain was triggered by swallowing, yawning, or cold food. We used the anterior tonsillar pillar method for the injection of drugs; a relatively new glossopharyngeal nerve (GPN) block which was described by Benumof (Anesthesiology 1991;75:1094-1096). Performing this GPN block, daily levobupivacaine (Chirocaine® 5 mg/ml) and oral amitriptyline (Laroxyl® 10 mg) were given, as well as methylprednisolone acetate injectable suspension (Depo-Medrol® 40 mg/ml) once only at the beginning of the treatment. A 0-10 point visual analogue scale was used daily to evaluate the pain. Pain was successfully controlled with a steroid added to the GPN block and orally administered tricyclic antidepressant. We think that this treatment is effective for glossopharyngeal neuropathy and could be of interest to pain management physicians.

No MeSH data available.


Related in: MedlinePlus

The tongue is swept to the opposite side by a laryngoscope. A 25-gauge spinal needle is inserted 0.5 cm deep, just lateral to the base of the ATP and 2 ml of levobupivacaine (5 mg/ml) is injected on both sides.
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Figure 1: The tongue is swept to the opposite side by a laryngoscope. A 25-gauge spinal needle is inserted 0.5 cm deep, just lateral to the base of the ATP and 2 ml of levobupivacaine (5 mg/ml) is injected on both sides.

Mentions: We used the anterior tonsillar pillar (ATP) method, a relatively new glossopharyngeal nerve (GPN) block for the injection of drugs, which was described by Benumof [3]. We chose the ATP method, because the ATP is easily exposed and tongue movement does not elicit the gag reflex, besides patient tolerence is good. In this method, the tongue is swept to the opposite side. A 25-gauge spinal needle is inserted 0.5 cm deep, just lateral to the base of the ATP (fig. 1) and 2 ml of levobupivacaine (Chirocaine® 5mg/ml) is injected on both sides daily.


Treatment of a patient with glossopharyngeal neuralgia by the anterior tonsillar pillar method.

Isbir CA - Case Rep Neurol (2011)

The tongue is swept to the opposite side by a laryngoscope. A 25-gauge spinal needle is inserted 0.5 cm deep, just lateral to the base of the ATP and 2 ml of levobupivacaine (5 mg/ml) is injected on both sides.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3064862&req=5

Figure 1: The tongue is swept to the opposite side by a laryngoscope. A 25-gauge spinal needle is inserted 0.5 cm deep, just lateral to the base of the ATP and 2 ml of levobupivacaine (5 mg/ml) is injected on both sides.
Mentions: We used the anterior tonsillar pillar (ATP) method, a relatively new glossopharyngeal nerve (GPN) block for the injection of drugs, which was described by Benumof [3]. We chose the ATP method, because the ATP is easily exposed and tongue movement does not elicit the gag reflex, besides patient tolerence is good. In this method, the tongue is swept to the opposite side. A 25-gauge spinal needle is inserted 0.5 cm deep, just lateral to the base of the ATP (fig. 1) and 2 ml of levobupivacaine (Chirocaine® 5mg/ml) is injected on both sides daily.

Bottom Line: Performing this GPN block, daily levobupivacaine (Chirocaine® 5 mg/ml) and oral amitriptyline (Laroxyl® 10 mg) were given, as well as methylprednisolone acetate injectable suspension (Depo-Medrol® 40 mg/ml) once only at the beginning of the treatment.Pain was successfully controlled with a steroid added to the GPN block and orally administered tricyclic antidepressant.We think that this treatment is effective for glossopharyngeal neuropathy and could be of interest to pain management physicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Harput State Hospital, Ministry of Health of Turkey, Elazig, Turkey.

ABSTRACT
We describe the case of a 65-year-old patient with glossopharyngeal neuralgia. Pain was triggered by swallowing, yawning, or cold food. We used the anterior tonsillar pillar method for the injection of drugs; a relatively new glossopharyngeal nerve (GPN) block which was described by Benumof (Anesthesiology 1991;75:1094-1096). Performing this GPN block, daily levobupivacaine (Chirocaine® 5 mg/ml) and oral amitriptyline (Laroxyl® 10 mg) were given, as well as methylprednisolone acetate injectable suspension (Depo-Medrol® 40 mg/ml) once only at the beginning of the treatment. A 0-10 point visual analogue scale was used daily to evaluate the pain. Pain was successfully controlled with a steroid added to the GPN block and orally administered tricyclic antidepressant. We think that this treatment is effective for glossopharyngeal neuropathy and could be of interest to pain management physicians.

No MeSH data available.


Related in: MedlinePlus