Thesis (Ph.D)-Cairo University, 2024.

Bibliography: pages 84-96.

Background: . Oral cancers, along with oropharyngeal cancers, are the sixth most common malignancy worldwide. Globally, over 400,000 estimated new cases of oral cancer are diagnosed each year.oropharyngeal cancer risk factors include human papilloma virus, smoking, alcohol use. Glossopharyngeal neuralgia is an extremely uncommon occurrence and accounts for only 0.2%–1.3% of the cases with facial pain. As per ICHD-3 (International Classification of Headache Disease- 3) classification, glossopharyngeal neuralgia is a disease characterized by an episodic unilateral pain, with sharp and stabbing in character, with sudden onset and cessation, in the glossopharyngeal nerve distribution (jaw angle, ear, tonsillar fossa and the base of the tongue). It also affect the pharyngeal and auricular branches of the vagus nerve. Pain is commonly aggravated by coughing, talking, and swallowing. Pain in glossopharyngeal neuralgia has a relapsing and remitting pattern.
According to pain of oropharyngeal cancer, it is rarely pure somatic, visceral or neuropathic types but rather is a complex syndrome due to mixed mechanisms either inflammatory, ischemic or neuropathic.
The treatment of glossopharyngeal neuralgia could be pharmacological or surgical. The first line of treatment is pharmacological. Surgical options should be considered in situations of drug intolerance, inefficacy or allergies. The pharmacological line of treatment for GPN includes the anticonvulsant medications or pregabalin.
Because the pain is relatively resistant to traditional analgesics, sometimes pain relief can only be achieved at the expense of drug related side effects. Early interventional pain treatment can therefore bypass these overruling side effects and increase the faith of the patient in the pain physician.
The aim of this study is to evaluate the safety and efficacy of supervoltage pulsed radiofrequency glossopharyngeal nerve therapy versus standard pulsed radiofrequency in reduction of oropharyngeal cancer pain, through Visual analog scale score reduction.
Methods: Sixty patients with refractory pain due to oropharyngeal malignancies were divided into two groups each of which was 30 patients.
The 1st group underwent super-voltage pulsed radiofrequency nerve block and the 2nd group underwent standard voltage pulsed radiofrequency nerve block.
Visual analogue scale (VAS) for pain, morphine sulphate tablets and gabapentin capsules drug consumption were recorded prior to procedure and 1 day,1 ,2 ,3, 4 weeks, 2 months and 3 months after the procedure. Adverse effects of the procedure were reported.

Results: There was decrease in pain score, morphine and gabapentin consumption in group (A) than group (B) after the procedure during the study period compared to values before the procedures.
Conclusion: Super-voltage pulsed radiofrequency glossopharyngeal nerve block is more effective than standard-voltage pulsed radiofrequency to relief pain due to secondary glossopharyngeal neuralgia due to oropharyngeal cancer and safe procedure.

الطرق: ستون مريضا بسرطان الفم والحلق يعانون من آلام لا تستجيب للعلاج الدوائى تم تقسيمهم الى مجموعتين كل مجموعه بها ثلاثون مريضا.
المجموعه الاولى تم فيها عمل تردد راديوى نبضى ذو جهد فائق على العصب التاسع.
المجموعه الثانيه تم عمل تردد راديوى نبضى قياسى على العصب التاسع.
وقد تم حساب مقياس الالم التماثلى البصرى ومعدل استهلاك مسكن المورفين والجابابنتين قبل التدخل وبعده بيوم ‘(1‘2‘3‘4) اسابيع وكذلك بعد شهرين وثلاثه اشهر ، كما تم تسجيل حدوث المضاعفات الجانبيه للتدخل .
النتائج: وقد اظهرت الدراسه تقليل درجه الالم فى المجموعه الاولى عن الثانيه وقد دلل على ذلك بنقصان مقياس الالم التماثلى البصرى ومعدل استهلاك مسكن المورفين والجابابنتين بعد التدخل عن ذى قبل.
الاستنتاج: ان استخدام التردد الراديوى النبضى ذو الجهد الفائق وسيله فعاله عن استخدام التردد الراديوى النبضى القياسى كطريقه لتخفيف الالم وتقليل استهلاك المسكنات فى حالات نيورالجيا العصب التاسع الثانويه الغير مستجيبه للعلاج فى مرضى سرطان الفم والبلعوم.

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Text in English and abstract in Arabic & English.