Cryoablation of the superficial cervical plexus for post cochlear implantation lesser occipital neuralgia.

Abstract

Objective and importance: Chronic pain following cochlear implantation (CI) is a notable complication that can lead to device explantation. This case report describes the successful treatment of post-CI lesser occipital neuralgia using cryoablation of the superficial cervical plexus (SCP).

Clinical presentation: A 25-year-old female patient developed localized pain following CI reimplantation, presenting with allodynia and dysesthesia in the left lesser occipital nerve distribution. After a positive diagnostic SCP block providing temporary relief, ultrasound-guided cryoablation was performed.

Conclusion: The procedure resulted in complete pain resolution and anesthesia in the distribution of the lesser occipital, greater auricular, and transverse cervical nerves. While pain recurrence occurred after seven months necessitating repeat treatment, the intervention proved to be a safe and effective management strategy for post-CI neuralgia. This case demonstrates that SCP cryoablation may offer a viable, minimally invasive solution for patients experiencing post-CI neuralgic pain, with the potential for repeated applications as needed.