Ultrasound-guided pulsed radiofrequency of zygomaticotemporal nerve for refractory temporal headaches.

Temporal headaches may originate from entrapment of the zygomaticotemporal and the auriculotemporal nerves, which serve as potential trigger points. Conventional interventional management includes local anaesthetic blocks or surgical decompression; however, pulsed radiofrequency of the zygomaticotemporal nerve has not been previously reported. We describe two patients with refractory temporal pain treated with ultrasound-guided pulsed radiofrequency of the zygomaticotemporal nerve. A 54-year-old man with post-traumatic neuralgia achieved sustained relief for over 5 months after two sessions, while a 34-year-old woman with migraine without aura achieved sustained relief for over 4 months after a single session. The block is relatively superficial, has a short learning curve under ultrasound guidance and is well tolerated. Pulsed radiofrequency of the zygomaticotemporal nerve may be considered as a promising minimally invasive and reproducible therapeutic option for patients with temporal headaches.