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Correspondence to Author: Dr.Ahmet koçer 

Bakircay University Cigli Training and Research Hospital

DOI: 10.52338/jop.2026.5610

Abstract:

Introduction: External nasal neuralgia is a significant yet rare cause of facial pain. This pain can arise from various central and peripheral etiologies. Due to its complex pathophysiology, it is often overlooked and misdiagnosed. Various treatment options are available for managing this pain, including pharmacological and interventional therapies. Its rarity and the lack of standard treatment options make this condition particularly significant. In our experience, an effective treatment approach must take into account both local inflammatory factors and abnormal nerve modulation. In this study, we aimed to evaluate the effect of pulse radiofrequency (PRF) treatment on pain intensity and the dose of analgesics used in patients diagnosed with external nasal neuralgia.
Method: In this study, a total of 8 patients were examined, comprising 1 patient with a history of trauma and 7 without any history of trauma, all of whom presented with pain in the nasal and perinasal regions. Data on the patients’ age, gender, pain localisation, visual analogue scale (VAS) score at the time of clinic visit, and VAS scores at weeks 4 and 12 following pulse radiofrequency (PRF) treatment, as well as the doses of opioid and adjuvant medications used, were recorded.
Results: A total of 8 patients were included in the study, comprising 50% women and 50% men. The patients’ VAS scores at the time of initial presentation were found to be 8,16±1,18 on average. The mean VAS scores at weeks 4 and 12 post-treatment were 1.96±1.12 and 2.00±1.07, respectively; statistically significant differences were found compared to baseline pain (p < 0.001, p < 0.001). Regarding systemic analgesic treatment; patients using tramadol , pregabalin , gabapentin , duloxetine and amitriptyline were observed to have a significant reduction in the doses required for pain control during post-procedure follow-ups.
Discussion: In patients with pain, significant clinical improvement was achieved by applying pulsed radiofrequency to the external nasal nerve in addition to first-line neuropathic pain treatment (one patient received both sphenopalatine and external nasal nerve PRF, whilst another patient received Gasser RF ablation and external nasal nerve PRF). Pulse radiofrequency (PRF) treatment is considered an important treatment option due to its low risk of side effects (as it is not a neuroablative treatment), the patient’s avoidance of side effects associated with the systemic medication load, and its distinct mechanism of action. It has been observed that pulse radiofrequency (PRF) treatment, when applied to patients with neuropathic pain associated with external nasal neuralgia, is effective in the short and medium term in terms of both pain intensity and the need for systemic medication.

Citation:

Dr.Ahmet koçer, Pulsed Radiofrequency Of The External Nasal Nerve For External Nasal Neuralgia. Journal of Pain 2026.