Treatment of a Patient with Glossopharyngeal Neuralgia by the Anterior Tonsillar Pillar Method

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(R) 5 mg/ml) and oral amitriptyline (Laroxyl(R) 10 mg) were given, as well as methylprednisolone acetate injectable suspension (Depo-Medrol(R) 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.