PMC8541760_01
The pain area changes of the patient. (A) Pain area before all treatments. (B) Pain area after the first PRF treatment (C2 dorsal ganglion and left superficial cervical nerves).
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At that time, the specific pain area was in the left auricle, behind the ear, occipitalia and neck (Figure 1A). Fortunately, pain symptom was improved, and the pain area was also reduced, mainly concentrating on the auricle and part of the external ear (Figure 1B), except for complete numbness he felt in the left head and neck.
The radiofrequency ultrasound images of the GAN puncture. (A) The yellow area represented the sternocleidomastoid (SCM) muscle, and the blue area represented the GAN. (B) The yellow area represented the SCM muscle, the blue area represented the GAN, and the red area represented the radiofrequency needle.
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Under the guidance of high - frequency ultrasound (Frequency: 10 MHz), the GAN was identified by a 22G * 10cm * 5mm radiofrequency electrode trocar with a transverse in-plane approach (Figure 2A and B), which was inserted into the GAN, and then the inner needle of the trocar was retracted. Figure 2B showed the complete route of the radiofrequency needle entering the body and the location of the tip to the GAN.
Pain area after PRF treatment of the GAN.
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When he was discharged on 7 d after surgery, the NRS score was 2, the pain scope was narrowed and concentrated on the external auditory canal screen (Figure 3), the numbness (when he regarded degree of numbness at admission as 100%) was relieved to 40%, the SSS score was still 41, the PHQ-9 score was 5, and the GAD-7 score was 4, as discharged after 7 d post-op.