【原】【疼痛专题】射频消融治疗舌咽部神经痛的有效性:对当前文献的系统回顾

新用户9297xop8 2024-04-19 发布于北京

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Effectiveness of Radiofrequency Ablation for Treatment of Glossopharyngeal Neuralgia: A Systematic Review of the Current Literature

射频消融治疗舌咽部神经痛的有效性:对当前文献的系统回顾

论文摘要

Background: Glossopharyngeal neuralgia (GPN) is a rare cause of facial pain that has an incidence of less than one per 100,000 people. The excruciating stabbing pain experienced by patients with GPN can be debilitating, leading to difficulties in activities of daily living, such as eating and speaking. As a result, there has been a recent increase in research on the effectiveness of radiofrequency ablation (RFA) for treating GPN.

背景:舌咽神经痛(GPN)是一种罕见的面部疼痛的原因，发生率低10万分之一。GPN患者所经历的剧烈刺痛会使人虚弱，导致日常生活活动困难，如进食和说话。因此，近年来对射频消融(RFA)治疗GPN的有效性的研究有所增加。

Objective: The objective of our study was to evaluate the effectiveness of (RFA for treating GPN while examining its impact on patients’ quality of life and assesses for any associated side effects.

目的:本研究的目的是评估RFA治疗GPN的有效性，同时检查其对患者生活质量的影响，并评估相关的副作用

Study Design: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) model was employed to identify articles from 2 comprehensive medical databases. The patient outcomes and numbers from each article were aggregated and calculated in order to determine the percent efficacy of RFA for treating pain associated with GPN.

研究设计:采用系统评价和荟萃分析首选报告项目(PRISMA)模型从2个综合医学数据库中识别文章。汇总和计算来自每篇文章的患者结果和数字，以确定RFA治疗GPN相关疼痛的疗效百分比。

Methods: In this systematic review, the PRISMA review model was utilized to search through the PubMed and EMBASE databases. A comprehensive literature review was conducted. Of the initial 1,580 articles identified, 18 articles were included for analysis. Studies included in this systematic review encompassed idiopathic cases and secondary causes, such as an elongated styloid process, oropharyngeal cancers, and postsurgical/traumatic pain.

方法:本系统综述采用PRISMA综述模型对PubMed和EMBASE数据库进行检索。我们进行了全面的文献综述。在最初确定的1 580篇文章中，有18篇文章被列入分析。本系统综述纳入的研究包括特发性病例和继发性原因，如茎突延长、口咽癌和术后/创伤性疼痛。

Results: Of the 288 patients treated with RFA, 231 experienced relief or complete resolution of pain, yielding an efficacy rate of 80.2%. Most of the patients experienced immediate pain relief after RFA; however, some patients reported numbness, dysphagia, and changes in taste. Our study examines the potential use of RFA as a minimally invasive and effective treatment for GPN.

结果:288例RFA患者中，231例疼痛缓解或完全缓解，有效率为80.2%。大多数患者术后疼痛立即缓解;然而，一些患者报告麻木、吞咽困难和味觉变化。我们的研究探讨了RFA作为GPN的微创和有效治疗的潜在用途。

Limitations: Limitations of our study include the absence of comparisons between different types, modes, and settings of RFA procedures. The use of only 2 medical databases is another limitation. Finally, our systematic review does not include any randomized controlled trials.

局限性:本研究的局限性包括缺乏不同类型、模式和RFA程序设置之间的比较。仅使用2个医学数据库是另一个限制。最后，我们的系统综述不包括任何随机对照试验。

Conclusion: RFA is efficacious in treating GPN with over 80% of patients experiencing postprocedure pain relief. However, further research in the form of clinical and controlled trials is needed to contribute to a better understanding of RFA’s long-term outcomes for patients with GPN.

结论:RFA治疗GPN有效，80%以上患者术后疼痛缓解。然而，需要以临床和对照试验的形式进行进一步的研究，以更好地了解RFA对GPN患者的长期预后。

主要结果

1.After screening, our systematic review included a total of 18 articles for our study. In these 18 articles, a total of 288 patients with GPN were treated with RFA, either PRF or CRF. Of the patients treated, 231 of them experienced pain relief or complete resolution of their symptoms, which yields an efficacy rate of 80.2% for RFA procedures. 在这18篇文章中，共有288例GPN患者接受了RFA治疗，无论是PRF还是CRF。在接受治疗的患者中，231名患者的疼痛缓解或症状完全缓解，RFA手术的有效率为80.2%。

In this study, 231 of the 288 patients with GPN experienced pain relief or complete pain resolution after treatment with RFA, producing an efficacy rate that ranges from 66.7% to 100%.在本研究中，288例GPN患者中有231例在RFA治疗后疼痛缓解或完全缓解，有效率从66.7%到100%不等。

2.Elongated Styloid Process细长茎突

Swain and Mollinedo reported 2 case reports on patients who had GPN secondary to an elongated styloid process. The 2 patients reported in these studies had imaging that confirmed the presence of Eagle syndrome. Both were treated with a glossopharyngeal nerve block followed by PRF and experienced pain relief as assessed by their VAS scores。

报道了2例继发于茎突延长的GPN患者。在这些研究中报告的2例患者的影像学证实了Eagle综合征的存在。两名患者均接受舌咽神经阻滞治疗，随后进行PRF治疗，并通过VAS评分评估疼痛缓解。

3. Scarring After Surgery/Trauma 手术后的疤痕/创伤

Studies by van Tilburg,Sha, Aggarwal, and Salar treated patients who developed GPN after undergoing various kinds of surgery, such as nasal septum surgery, tonsillectomy, and styloidectomy. Chua, reported 2 patients who developed GPN, with one developing the condition after a tonsillectomy and the other after her neck was hyperextended. All 8 patients included in these studies were successfully treated with RFA and experienced a decrease in pain, although some of them never got complete resolution of their pain

van Tilburg等对鼻中隔手术、扁桃体切除术、茎突切除术后发生GPN的患者进行了治疗。Chua等报道了2例发生GPN的患者，其中1例在扁桃体切除术后发生，另1例在颈部过伸后发生。所有纳入这些研究的8名患者都成功地接受了RFA治疗，并经历了疼痛的减轻。

4.The articles published by Wang, Jia, Song,, Zhu, Telischak, Arbit, and Arias all included patients with idiopathic GPN or GPN with no reported secondary causes. Of the 235 patients, 189 achieved decreased pain or complete pain resolution after RFA treatment. This set of articles yielded an efficacy rate of 80.4% for RFA in patients with GPN.

Wang等人发表的文章均包括特发性GPN或未报道继发原因的GPN患者。在235名患者中，189名患者在RFA治疗后疼痛减轻或完全缓解。这组文章得出RFA治疗GPN患者的有效率为80.4%。

5.病例系列的偏倚风险评估: