title: Percutaneous trigeminal rhizotomy for facial pain secondary to head and neck malignancy.
abstract: BACKGROUND
  Nearly 80% of patients with head and neck cancers experience facial pain related to their tumor or treatment. The majority obtain pain relief with appropriate medical treatment. Occasionally some remain refractory to all analgesics or cannot tolerate the accompanying side effects. They may benefit from surgical intervention.
  
  
  OBJECTIVE
  We report a case of medically intractable facial pain secondary to squamous cell carcinoma of the tongue that was successfully treated with percutaneous trigeminal rhizotomy.
  
  
  METHODS
  Percutaneous trigeminal radiofrequency rhizotomy involves thermoablation of the trigeminal nerve within Meckel's cave by an electrode inserted through the cheek and foramen ovale.
  
  
  RESULTS
  Facial pain was successfully controlled postoperatively.
  
  
  CONCLUSIONS
  Percutaneous trigeminal rhizotomy is a surgical option for managing nociceptive pain secondary to a head and neck malignancy. This technique, last reported in the literature almost 30 years ago, must not be forgotten by the next generation of oncologists, pain specialists, and neurosurgeons.
authors: *Division of Neurosurgery, University of British Columbia †Pain & Symptom Management, Palliative Care, Vancouver Centre, British Columbia Cancer Agency, Vancouver, BC, Canada.
authors: Daniel
authors: D
authors: Mendelsohn
authors: Manish
authors: M
authors: Ranjan
authors: Pippa
authors: P
authors: Hawley
authors: Christopher R
authors: CR
authors: Honey
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000601:surgery*; D005157:Facial Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D019051:Rhizotomy / Q000379:methods*; D000077195:Squamous Cell Carcinoma of Head and Neck; D014062:Tongue Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000601:surgery*