Korean J Pain.  2013 Jan;26(1):84-88. 10.3344/kjp.2013.26.1.84.

Ultrasound-Guided Infraorbital Nerve Pulsed Radiofrequency Treatment for Intractable Postherpetic Neuralgia: A Case Report

• Lim SM
• Park HL
• Moon HY
• Kang KH
• Kang H
• Baek CH
• Jung YH
• Kim JY
• Koo GH
• Shin HY

• KMID: 1779031
• DOI: http://doi.org/10.3344/kjp.2013.26.1.84

Abstract

A 60-year-old man presented with pain on the left cheek and lateral nose. The patient had been diagnosed with facial herpes zoster in the left V2 area 6 months previously. Medical treatment was prescribed for 6 months but it had little effect. We blocked the left infraorbital nerve under ultrasound guidance, but pain relief was short term. Therefore, we performed pulsed radiofrequency treatment on the left infraorbital nerve under ultrasound guidance. Six months after the procedure, the reduction of pain was still maintained, and there was no need for further management.

Keyword

infraorbital nerve; radiofrequency; ultrasound

MeSH Terms

Cheek
Herpes Zoster
Humans
Nose
Pulsed Radiofrequency Treatment

Figure

• 

  Fig. 1 A photograph of the radiofrequency needle placement under ultrasound guidance (10-12 MHz linear transducer). (A) In the actual patient. (B) Anterior view in a human skull model, which is empirically depicted. (C) Lateral view in a human skull model, which is empirically depicted. The ultrasound transducer was initially applied longitudinally at the lateral side of the nose and rotated slightly clockwise. Then, the transducer was moved laterally until the left infraorbital foramen was identified.

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  Fig. 2 An ultrasound image of the radiofrequency needle in the infraorbital foramen (10-12 MHz linear transducer, long-axis in-plane technique). The protuberance within the hyperechoic line indicates the infraorbital foramen. The radiofrequency needle through the infraorbital foramen is indicated with arrow heads.

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  Fig. 3 Fluoroscope images during pulsed radiofrequency treatment of the left infraorbital nerve. (A) Anteroposterior view. (B) Lateral view. Fluoroscopic images show that the needle was in the infraorbital foramen and not in the orbital cavity. No vascular uptake of radio-contrast agent was observed.

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