Peripheral nerve stimulation for Sphenopalatine Ganglion and auriculotemporal nerve in refractory Posttraumatic Trigeminal Neuropathy.

BACKGROUND: Chronic facial pain has varying causes and etiologies. Often, diagnosis and management require a combination of pharmacological and surgical interventions. Externally powered peripheral nerve stimulation (PNS) is an emerging treatment for refractory facial pain. This report describes a case of combined auriculotemporal nerve stimulation (ATNS) and sphenopalatine ganglion stimulation (SPGS) for a patient with complex facial pain. CASE REPORT: A 74-year-old man with a decade-long history of intractable facial pain, following traumatic injuries, underwent a temporary PNS trial of combined ATNS and SPGS using the Freedom® PNS System (Curonix). The trial resulted in significant pain reduction and sustained relief for over 18 months post-removal. CONCLUSIONS: Long-lasting relief following a short-term trial suggests that ATNS and SPGS neuromodulation may produce enduring benefits after device removal. These findings warrant further investigation into the mechanisms and broader application of PNS in treating complex facial pain.